Americas Heartbeat by International Federation of Medical Students' Associations

Americas Heartbeat Health Equity.

JULY 2016

Editorial Ignacia Alvarez RD Americas Contribution Ivan Canaval Internal development Diego Mendoza involvement assistant Aline D.Khatchikian SCOPH RA Carlos Acosta SCORA RA Rodrigo Roa SCOPE RA Mauro Camacho SCORE RA Francisco parra Capacity Building RA Lucas Rodrigues SCOME RA Hana Awil SCORP RA Articles by Members from the Americas region

A publication by the International Federation of Medical Students Associations.

BY IGNACIA ALVAREZ

Dear Members of IFMSA and partners With great enthusiasm I would like to present you our regional publication, the Americas heartbeat, that represents the work and ideals of the national members organization of the Americas region in the International Federation of Medical Students Associations. This magazine was constructed to publish and share with our beloved IFMSA, external partners and general medical students, the activities that are currently been organized by the 27 national member organizations that currently form the Americas region within the Federation.

The Americas heartbeat, was created several years ago with the dream of straightening out institutional memory, inspire our members and share our projects in the hopes of becoming a collaborative region of medical students that work together for a better and healthier future. A long time has passed since our last publication, but I do hope that the tradition will persist so we will be able to excitingly review the growth of our region and federation through the pages of the Americas heartbeat. I would like to thank my amazing regional team, the IFMSA team of officials, the national member organizations of the region, and each member who took the time to share their experiences and thoughts through this publication.

JUNE 2016

THEME EVENT Message from the Regional Director team 6 Theme event articles 7-22

SCOPH Message from the SCOPH RA 24 SCOPH articles 25-35

SCOPE AND SCORE

SCORA

Message from the SCOPE and SCORE RAs 37

Messages from the SCORA RA 69 SCORA articles 70-81

SCOPE and SCORE articles 38-43

SCORP Message from the SCORP D 45 SCORP Articles 46-53

SCOME Message from the SCOME RA 55 SCOME Articles 56-67

CAPACITY BUILDING SRT Quito SRT MÃ©xico

THEME EVENT HEALTH EQUITY IN THE AMERICAS

Regional Director team

Diego, Ignacia and Ivan Dear Americas Being the regional team of the Americas it's a great and exciting challenge, we face the responsibility of leading one diverse, passionate and heterogeneous region. The region of the Americas in the International Federation of Medical Student's Association is knows for great leaders, thoughtful initiatives and great compromise with the national, and global public health efforts. The Medical students from North, Center, South America and the Caribbean face different and uniques tasks in direct encounter with realities of our inequitable health systems and societies in the largest part of our continental geography. Therefore, our medical students, are equipped with an strong sense of social responsibility, passion for public health and enthusiasm to overcome the social challenges that threaten our populations health. The medical student's from the Americas also knows that the future of our countries and regions it's on their hands, and that many health challenges and outcomes rely on the personal and communal efforts we make. Our medical students are aware that we will not only work as physicians, but that our duty will also be as social leaders and powerful makers of change. This magazine collects all of our regional national member organizations hard work, activities, hopes and challenges when working with communities, medical students and global population, also providing with an interesting and picturesque overview of the numerous fields that our members work in and the countries backgrounds and realities. It's an honor to me to present you our new edition of the Americas heartbeat, the regional publication that collects our members activities, projects and ideas in the hopes for a better, healthier and more equitable region. The regional team couldn't be prouder of the Americas We hope you enjoy Ignacia Alvarez - Regional Director for the Americas Ivan Fabrizzio Canaval - Internal development assistant Diego Mendoza - Involvement assistant.

Unequal Health Systems vs Equality Edwin José Cañate Rueda ASCEMCOL-Colombia

The human being is born under the belonging designation to a group, religion, culture, economic society and, education among others, which is part of all of us and deserves respect, bearing in mind that we are all human beings and that makes us equal, the sense of humanity is so great that there comes the equally recognition, regardless of the differences that constitute us; the ideals underlying a civilization and that brings order are the human rights basis for the development and organization at the time that we forget that there begins a process of deterioration and decline. Among the most important rights that men and women have, health is a fundamental right, which is based on equity in health for all people regardless of their origin.

I began to observe this mentioned reality when we were in the clinical care setting, in health centers in Colombia. This generates a series of feelings, hopes and dreams devastated, where we wonder if we will continue this unequal system in which the sense of humanity is receded into the background or even exist. However, when making my autonomous decisions, I will decide to don’t take part of this health resort, because I will always have the option to make a difference, to continue my ethical and moral principles: when I see a human being, I am aware that is part of me, he deserves the same attention, care and respect. I would like, and I’m sure that this is not only an ideology, that many of us think the same, and together, we can change this model of health in Colombia and the world. The human being is surprisingly able to make changes in a transcendental way, the sense of rescuing health equity is a challenge we can meet, for this purpose there life and commitment, there is hope and change.

In some regions of the world including Colombia, people are classified or labeled according to the agreement the promoter of health had with the health providing institution the person is affiliated, providing levels of care and different personal treatment, because the health system is formed to give excellent, good, fair, poor or no health care according to your affiliation, regardless of the clinical condition that takes you to the health institution, because it is only matter of where you are from or belong, health is managed by an exclusive economic and financial system, where equity in health is a myth. Equity in health is a myth, because when we were formed as doctors, we are taught that we are all equal, we should and we must receive the best possible treatment. We are not taught to make a personal classification of the patient in relation to its health system.

IFMSA: Empowering young doctors as a health equity tool for our region Ignacia Alvarez IFMSA-Chile

The region of the Americas has a long history of fighting against inequities in all sorts of social scenarios since the very beginning of the written evidence debut of our existence as nations. Inequity was brought to us as a colonization tribute, and we have been fighting that legacy since the brave independency of our countries and region.

As an example, racial and ethnic minorities continue to experience higher rates of morbidity and mortality than non minorities across a range of health issues (2), but since the extent of disparities and inequities we face in the Americas is disturbingly wide, we must start addressing this issues as regional concern with a wider scope. Defining the most relevant inequities in our region will only help to scatter our endeavours.

Even though the reality of our region is heterogenous in geography and social demographics, the fights for equal conditions throughout the ages are inspiring by the outcomes and perseverance of our American leaders; from the women's rights movement in the USA during the nineteenth century, the victorious achievement of universal health coverage in the caribbean island of Cuba and the effective social movement for LGBTQ equal rights in South America, the constant and resilient fight for equality has been deep encrusted in our idiosyncrasy.

Moreover, developing countries in our region are adopting health promotion as an appropriate and key approach to address the social determinants of health, inequities and the challenges associated with the epidemiological transition from infections to chronic diseases, urbanization and globalization that we are facing daily based on the provided recommendations of successful interventions made by Pan American Health Organization (PAHO).

Progress has been made, but we are still far behind of the worldâ&#x20AC;&#x2122;s development standards in terms of equity in economic, social and cultural aspects. Together, As medical students, we need to start acknowledging all the previously mentioned inequities as our daily fight, but Health inequity it's becoming a very personal struggle in our daily lives as trainees and future practitioners. Health equity can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health care, and quality of health care regardless of one's race, gender, nationality, age, ethnicity, religion and socioeconomic status. (1) Despite significant improvements in the health of the overall population, health inequities in America persist.

The PAHO, as the leading organization for health issues in our region, greatly summarized the successful interventions, such as the implementation of of national health promotion policy plans, health policies aimed at decreasing risk factors and diseases, as well as policies applied to other sectors and that focus on social determinants of health made by different regional nations and proposed different strategies for communities and nations to overcome the challenges associated with health inequalities and disparities. I found especially interesting, that one of the proposed approaches for the matter was the promotion of local development and social participation, adding to the definition of health equity, a comprehensive social and political process that not only embraces actions geared toward strengthening the skills and capabilities of 8 individuals,

, but also actions to change social, environmental and economic conditions so as to alleviate the impact on public and individual health (3). This interesting perspective made me realize from a new angle the strong impact that the IFMSA does in our ourselves, communities and societies and how our capacity building events and fulfilling IFMSA careers throughout our medical studies that aims on increasing leadership skills, public presentation, advocacy strategies and create strong, outcome oriented interventions to our communities are recognized by the world leading health institution as effective approaches to increase the health equity in our region. After all, I can only just finish by adding: We are truly changing the world! References: 1South Asian Health Project, â&#x20AC;&#x153;Definition of Health Equity,â&#x20AC;?available at <http:// www.southasianhealth.org/healthequity.aspx> 2A Strategic Framework for Improving Racial/Ethnic Minor- ity Health and Eliminating Racial/Ethnic Health Disparities, Retrieved October 6, 2010, from Office of Minority Health, available at <http://minorityhealth.hhs.gov/npa/ images/78/ PrintFramework.html> 3-Trend and Achievements in Promoting Health and equity in the Americas: Developments from 2003-2011. Pan american Health Organization/World health organization

Non formal education as a proposal for health equity in the Brazilian Public health system

Thays Brunelli Pugliesi,Tais de Lima Oliveira, Thais Iwashita Lages, Mario Fernando Dantas Gome IFMSA-Brazil The Brazilian health care system, the Unified Health System - in portuguese, Sistema Único de Saúde (SUS) - is one of the largest public health systems in the world. According to the law regulated in 1988, SUS was born to reassert that health is a fundamental human right, and the state must provide the necessary conditions for its full realization. To this end, SUS is guided by principles and guidelines based on universal access to health services, integrity and equal assistance.

money and resources and the application of social actions and health research as measures to combat health inequality. Through the projects we have done and the discussions we have made, as well as the creation of our Policy Statements, we are able to share our difficulties and successful events with the Americas, so we can look for solutions and advocate for the same causes, together.

The system consists of three levels of funding sources - federal, state and municipal. It has a complex network of services ranging from simple, such as primary care, to specialized care. The infrastructure consists of outpatient clinics, emergency rooms and hospitals, including teaching hospitals. An example of health equity offered by SUS is the free treatment for HIV/AIDS. In USA, for example, the treatment costs around US$ 2.000 per month. However, in a country with continental dimensions, Health Equity seems a little too difficult yet. According to recent data, about 60% of the brazilian population is unhappy with the quality of the health system. This is due to long queues and lack of human resources. In this reality, there are institutions that seek to balance inequities and difficulties inside the country. IFMSA Brazil enters in this gap supplying the demand with advocacy . The members identify the brazilian health problems locally and organize projects and actions with the community. Also, the institution provides several discussions into the academic life giving opportunity for improvements 10 and changes in the medical grade.

References: Minitério da Saúde Brasileiro. Entenda o SUS. Disponível em <http:// portalsaude.saude.gov.br/index.php/cidadao/entenda-o-sus>. Acessado em 11/01/2016. LEI Nº 8.080, DE 19 DE SETEMBRO DE 1990. Presidência da República. Disponível em <http://www.planalto.gov.br/ccivil_03/Leis/L8080.htm>. Acessado em 11/01/2016.

AM 2016, An American Goal Luis Gatti Pineda IFMSA-Paraguay

AM 2016, an american goal: To achieve the active participation in the international assemblies is not easy. A lot of kilometers, airplane tickets that on average cost more than 1.500 USD, the change in time zones, the jet lag, the long hours traveling, but it all pays off. As we know, participating in a GA does not compare to anything. Now, why is the August Meeting in Mexico so important to me? Because it offers an approach to the highest international estate to the americas, giving various american countries the possibility to participate, some for the first time, in such an important event. The feeling is beyond great, since in august, America, through Mexico, will not only participate in a general assembly, but it will also be a place to reunite after three long years of american confraternity. Viva Mexico! Viva America!

Health Equity in Peru Ivan Fabrizzio Canaval IFMSA-Peru

For the World Health Organization Health Equity is the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically. For us is as simple as the palpable daily reality in our countries. The Americasâ&#x20AC;&#x2122; regional context, in terms of Health equity, is something we need to deal in our daily life, mainly because access to health service is not the same for the population in terms of infrastructure, medical resources, human resources, economical access and geographical access. In health, there are different ways to assess equity: equity coverage, equity in distribution of resources, equity in health, financial equity, equity in access to health services and equity in the use of resources. Seeing equity on the side of access, according to data from the National Survey in Peru, indicates that the population accessed health services 78.9% of the total that had an illness or accident and did not had access to health services 21 ,1%. This makes me ask the next question: What does access to health service means for those people, In the same survey 34% of the people answered that "health service" for them is the possibility to go to a pharmacy or drug store and self-medication, and this made me think deeply in terms of how devalued is the definition of health service in my beloved country. If we talk about access to health services by levels of poverty, there is a direct relationship between poverty and lesser access: the population's access to health services is classified not poor, 58.5%; poor, 27.4% and the extreme poor in 14.2% of the 12 population who accessed health services.

Those who do not have access, they are obviously the poorest, many of whom do not attend health services simply because they prefer home methods (can be traditional medicine) or because they simply do not have enough money to pay the fees for consultations. The plot thickens if we analyze who attended a health service and can pay consultationâ&#x20AC;&#x2122;s fee but have no money to buy medicine and follow the prescribed treatment. This is a way to show, from my countryâ&#x20AC;&#x2122;s reality, how much is needed the interest of medical students and future physicians in health equity and the need to unite effort to fight against the inequities in health since these social determinants will affect our population and in the same line, the progress of our countries, communities, families and our self-progress as health professionals.

Health Equity Related to Incidence of Lung Cancer and our roll as medical students. Karen Dominguez Marchand, Brandon Morales Pineda, José Arturo Ruiz Reyes, Augusto Rafael Valle Valdez. IFMSA-México

Lung cancer is the first place of mortality in the world, it represents the main health problem on oncology theme and one of the most important in general, being the cause number 10 in global death. The incidence rate is 62/100,000 with an average age of 70 years old. The 15% of the patients has a local disease and 56% metastatic at diagnosis time , with a rate of global survival of 5 years only 16%.

Several pathways have been identified that link lower neighborhood socioeconomic status to smoking, unhealthy diet, physical inactivity, and excessive alcohol consumption. May shape a resident’s exposure to the availability of local amenities and resources, such as park and recreation facilities, food markets, and tobacco and alcohol outlets and advertising. Local community networks and norms, attitudes, belonging, and knowledge about healthy lifestyles. 1

In México the incidence is 9,148 cases (7%) and the mortality is 11%. The INEGI reports 74,685 deaths by cancer in 2010 (13% of deaths in México). Being 68% in man. Is the first cause of death by neoplasia, knowing that the the risk factor is tobacco which is present in the 90% of the cases. Lung Cancer origins when the cells begin to reproduce on a aleatory way, forms a tumor and then migrates to other parts of the organism forming new tumors. This process generally starts in the cells that involve the bronquios.

As such, richer neighborhoods socioeconomic status typically have more health promoting events t, which support the pursuit of a healthy lifestyle and the avoidance of unhealthy behaviors. Little research has examined occupational exposures as a mediating pathway of neighborhoods socioeconomic status effects; however, living in low SES neighborhoods may shape occupational opportunities towards working class or “blue collar” jobs that are associated more frequently with exposure to cancer causing substances, such as asbestos, arsenic, beryllium, cadmium, chromium, diesel engine exhaust, and silica.1

Lung cancer represents approximately 18% of all cancer deaths worldwide. The incidence rates in different countries are significantly higher among disadvantaged population as well as low-income areas. These differences remain after removing the individual smoking behavior rates, and other other established lung cancer risk factors as well.The patient’s neighborhood socioeconomic status may influence an individual’s health behaviors and health status through numerous material and psychosocial pathways. The role of neighborhood socioeconomic status in shaping lung cancer risk, however, has not been adequately examined to date.1

Lung cancer represents an important public health problem that is strongly related to the unequal access to health and which has not been given sufficient attention by governmental and nongovernmental institutions and organizations related to health, similar effects occur in general populations. As we could read in the previous paragraphs, socioeconomic and cultural levels play a very important role on the incidence of the discussed disease, as well as the access to quality treatment and early diagnosis; because, for people living in lowincome neighborhoods, their own environment

exacerbates the disease by not providing the minimum for a dignifying way to live and therefore didn’t promote healthy lifestyles. What we aim to expose with this, is that factors such as lack of health conditions at work, low incomes, bad nutrition, low neighborhood status, insecurity, and physical inactivity will always increase the risk of suffering lung cancer and any other non-communicable diseases. In order to start changing this factors, we as medical students need to start speaking out-loud and advocate against the unequal access to health, by promoting free screening campaigns in low income neighborhoods; demand to the government institutions to work in security issues so people can go to the streets and exercise, invest in public recreational spaces such as parks, to finance quality treatments, improve health and economical work conditions. In conclusion none of this work will be enough if national governments and general society don’t work together to improve and strengthen their legislation on tobacco consumption, free tobacco spaces and publicity control. Also increase the budget for health institutes, bound to lung cancer prevention campaigns as well as early diagnosis and quality treatment for population in general. So all actions done by different institutions and organizations working in lung cancer prevention, will decrease its incidence in middle to long term. References: 1-P. Hystad, et. Al., Neighbourhood socioeconomic status and individual lung cancer risk: Evaluating long-term exposure measures and mediating mechanisms. Social Science & Medicine 97 (2013) pp. 95- 103 2-M. Kovarik, et. Al. Clinically relevant determinants of body composition, function and nutritional status as mortality predictors in lung cancer patients. Lung Cancer 84 (2014) pp. 1–6. 3-M.E. Arcila, et. Al. Prevalence, Clinicopathologic Associations, and Molecular Spectrum of ERBB2 (HER2) Tyrosine Kinase Mutations in Lung Adenocarcinomas. Clinical Cancer Research. 18(18). Sep2012. Pp 4909- 4918. 4-J. Remon, et. Al. Lung cancer in women: an overview with special focus on Spanish women. Clin Transl Oncol. Nov. (2013). 5-M. Acuña T, Edgar Román B, Cáncer de Pulmón, Oncología, Guías Diagnósticas, Hospital General de México, (2013). 6-S. Sánchez, et Al. Cáncer pulmonar (1ra de 2 parte), E-Journal,UNAM (2005).

Millenium development goals for health equity Manuel A. RodrĂguez MD, Belkis J. Menoni-Blanco MD Alumnis FEVESOCEMVenezuela While itâ&#x20AC;&#x2122;s true that for a few years ago began the initiative and commitment of nations around the world to impose and achieve the Millennium Goals for health equity, this being a great advance in certain parts of America, it is also true the contrast in other regions where very modest gains seen tangible delays as far as goals are concerned and that only shows that the work ahead is still enormous, due to the persistence and worsening inequities that day by day are displayed, like pollution overflowing in the streets, beaches, rivers, sea and even worst in natural reserve places, which should be protected for wildlife.

They should prevent, and provide maternal and child health, instruct the mother to guarantee the education of their children and also provides health care for all without discrimination and with conviction to conserve and protect the environment. For all this, we say that the health team has a key role in achieving the Millennium Development Goals. Improve health facilities and medical education, will replicate knowledge to more people. FEVESOCEM in their struggle to provide a different point of view of health and helps the community, contributes to achieve the goals of the millennium, saying no to any kind of discrimination like people living with HIV, as well as health promotion and primary prevention with proper screening methods of plenty of diseases, and many other activities that encourage more members to the inclusion, education and progress.

Likewise another serious problem facing many countries in our region, has to do with the politicization and ideological education and the little coverage or deficiency childhood education systems that only increase the fruits and sow that we reap tomorrow weighing our children. The scarcity of supplies in hospitals and infrastructure worn by disorder, overload, and low maintenance of the same, deteriorate progressively the efforts as doctors could do to provide quality of life for our patients. It would follow a long list of deepening inequalities and problems facing our humanity, so we review only through this one small part of what are wrong to contrast and enhance what you can do in order to improve the environment around you and your people. Physicians carry the implicit desire to achieve the millennium goals for reach health equity. When training, not only looking for cure plenty of diseases but also educating the global community to obtain a better quality of life.

Finally this picture illustrates, the fact that our home, our planet, depend on us and we depend on it. We need to reflect and understand that we can have a sustainable growth and development; we must stop the uncontrolled and indiscriminate consumption of natural resources and redress the imbalance we have created over centuries of "development" with hundreds of thousands of tons of pollution and toxic discharges into the environment without any control or care. This change of mindset is not only facing in regard to the environment, but starts with our actions and human behavior as well. Itâ&#x20AC;&#x2122;s a fact that the foundations of any society relies in the family in which parents play a very important role to determine the future of new generations, an important commitment that every day becomes stronger, in order to combat inequality, discrimination, loss of moral and ethical values, failures in education and bad habits. It does not only depend on the survival of our species but of all that surrounds us. The Millenium Development Goals are symbolized in 8 basic steps, involving intervention in different areas but ultimately interact to achieve a better world, the world that we all want... If you want to change the world, start with change yourselfâ&#x20AC;Ś Mahatma Gandhi 1869 to 1948. Indian political thinker

The Yearning Hope of an Equal Health System throughout the Americas

María José Jaramillo Cartwright AEMPPI Ecuador

The Americas region may be the most diverse and unprecedented of the world. With a variety of languages, traditions, historical background and socio-economic development, we have become a tumultuous magnate in the rise throughout the years. Each of the 55 countries that conforms it can be qualified as anything but mundane, with its different ideologies and methodologies that are subsequently imprinted into their health systems. Even though in the world’s focus most of them may be seen as a developing ones that require many urbane improvements, I believe that they are anything but precarious. Still, we cannot negate that there is equity needed within our frontiers in many matters surrounding health.

Independently from the specific country we are dealing with, a health system should be able to deliver a high standard of quality service in order to satiate one of the most important people’s need: health. Given this, it should be considered that the systems are conformed by various elements that unite as a whole, initiating from personnel as nurses and doctors, to regulating entities such as governments. Each of these components need to be stable in furtherance of the process to work, and when one fails, a vital synchronicity is lost, as well as the ability to avoid higher morbidity and mortality rates. The problem of this resides basically in an economical matter, given that money may be a soothing factor for resource precariat. Still, we need to debunk that thought and be conscious that if we cooperate with one another, we can get stability of the components in an indirect way and improve all of our health systems together. Therefore, we have to become aware that the idea that money defines the limits of our capacities is obsolete, and stop the levity that has featured profoundly in our deliverance of services.

Being part of a developing country, one can realize the great difference that there exists in availability of resources within our health systems in the region. It is almost lurid to think that there are uncountable topics we learn in our classrooms, yet some of them are preceded by the words “these do not exist in our country”, “those are not affordable to our health systems” or “that will be only found/ used if you go practice medicine abroad” come in a ghastly manner. ¿Why will I not able to help my own country’s people to heal with the most novel techniques and why do fellow countries from my region have access to them, yet fail to mitigate our yearning needs? Sometimes, anger due to the lack of these resources may blind us, and we need to realize that it is not that countries or their governments are miser when it comes to health, but that it is in our hands as medical students to create an indelible change and accomplish equity in the health services delivered throughout the Americas.

Health should not be a topic from which people with power can swindle, but a vivid expression of how important is the wellbeing of the human race. After all, ¿is not that why we all chose this profession? It is fundamental that as medical students and health professionals that we understand the impact we can have in our own national and regional health systems. We should be tactful and responsible with our patients, indiscriminately of their specific characteristics, as well as our fellow international medical professionals. We arenot studying medicine only for a select few people, because if that would be the case maybe all of our knowledge would become strictly esoteric and our profession would be based in other kind of goals.

We are on our way of becoming doctors of the world, and creating our own pastiche of medical techniques and advancements for a better patient care across the globe. It is time that we become more methodical and objective for the sake of a common goal and in contemplation of the integral concepts that surround medicine. Additionally, we have to be able to surpass many barriers that are just being detrimental to the delivery of equal services of health to people throughout the region, initiating by the underlying difference between public and private health systems. Medicine, as many say, is a humanitarian profession. What we should care about when we have in front of us a patient is how are we going to improve their health, rather than how much they are able to spend. If we take as the most prominent factor the economical capability, then we are becoming presumptuous and precluding a personâ&#x20AC;&#x2122;s opportunity of access to health. A patient is still our patient in spite of their specific characteristics or origins. If medical students are able to understand that from initial stages of their instructive development, then maybe the prevailing practice will change and the services brought by both kind of entities, private and public, will be the closer to becoming the same. Equity is a great challenge, but we should not be intimidated by it. We have been building a long lasting mosaic with all of our effort and we are not stopping now. It is not implausible to achieve international cooperation and renouncing supposed disparities society has led us believe that exist within social stratums, nor is it extraneous that we deliberately start accomplishing change specifically for a better health system throughout the region. So, it is time for us to become pioneers and obliterate the great gap and differences between our frontiers in the matter of health. I cannot express anything but lamentation of the lack of strive we have achieved as a region to access an equal health service; yet I do lay an immense amount of hope in all the generations to come as the agents of change. The Americas have slowly become a powerful conflagration, and it is indispensable that we keep wide spreading our capability and work, in order to demonstrate how health is one of the most important rights that all of our people deserve and that we are zealously willing to deliver it to them.

Analysis of the current Brazilian political conjuncture

Roberta de Paola DENEM Brazil

Brazil's current political situation is complex and have been changing daily. When we look the historical analysis of the “Worker’s Party”( Partido dos Trabalhadores - PT) it clearly noticeable their gradual departure from the defense of the workers and social movements. Since the release of the "Letter to the Brazilian People" PT has ruled to keep Brazilian elite interests and profits intact. They try to approach the interests of two antagonistic and irreconcilable classes. As the ex- President of the Republic said, “Never bankers and businessmen profited as much as in recent years”. Therefore, its false polarization placed between the PT and its opposition, especially PSDB (Brazilian Social Democracy Entourage), as if they were essentially different in the model of government that they advocate and execute. What happens nowadays, that has been shown as an economical and political crisis, is consequence of the crisis of capitalism, which leaves the current gover nment even more vulnerable as a representative of an economic and social neoliberal policy. The government's inability to respond to the interests of the bourgeoisie with the speed and intensity that it demands, made this sector indicate the crisis as a result of mismanagement of the State by PT. But these crises are cyclical capitalism crises and are necessary for it to be sustained, no matter who is in government administration. Sectors of the opposition elite, however, take advantage of the current state of vulnerability and feed this ideological position and a national movement against the PT, making use of the media and legal apparatus. They just want to finish corruption, however, this strategy is used for decades to defend their class privilege and to remain in power.

On the other hand, the current measures taken by the government of Dilma, which seeks to make the country emerge from the economic crisis in the country, can’t be supported. This measures attack the workers strongly, for example, the policy of fiscal adjustment and budget cuts in sectors such as health and education . Currently, the crisis has only served to banks, in the middle of a fall of 3.8% of IGP seen on their profits grow, 15% reachs almost R $ 50 billion in profit - just considering the three largest private companies in the sector. Their interests of keeping high rates leading to recessionary crisis. At the same time, it is difficult to be friendly with measures such as the impeachment of President Dilma while there are no evidence of responsibility on crimes practiced by her. We know that an action of this precedent would open to other events that helps to keep the strengthening of the bourgeoisie, and in practice wouldn’t help with any popular demand, such as the fight against corruption. In the current moment, this legal tool will only serve as a mean of tensioning for more concessions if they do not materialize, or, consolidation of an opposition group that has actors involved, in many cases on corruption, as the attacked group. At this time, the most important thing is not who has power, but the State structure that impacts significantly the areas where it acts. While the mainstream media feeds attacks on the current government, we can see several attacks that go unnoticed (especially towards workers) at the same time. The president of the Chamber of Deputies, Eduardo Cunha, who had several allegations of bribery and omission of goods, leads a strong alliance with conservative sectors in the congress and attacks human rights. We had this period of approval of several 19 projects that will further

harm the Brazilian people: the law "anti-terrorism" that hurts the organizations of the working class; a project approved limiting public spending through the freezing of minimum pay.

Freedom of expression as a human right is respected only if, in any form of organization, defended and respected is right to be different and think and fight hatred and intolerance.

There was a design proposal limiting public spending through the minimum wage freezing and asking "voluntary" resignation of public servants. Approval of the general law of the state, privatizing at least 25% of all joint stock companies within 10 years. In addition, the government has defended the pension reform, which, for example, raises the minimum retirement age, an attack on workers' rights. The economic policies imposed on this time of crisis can have serious consequences for the NHS and the health of the population, especially the most vulnerable segments.

So there has been a risk to social rights, hindering access to health and education to the poor at the expense of strengthening a part of the population that is already economically favored and that, at the moment, do not share these resources. The Brazilian health system is built ruled on quality, gratuity, universality and equity but suffers several years of chronic underfunding, combined with it, is facing the entrance of privatizing forces that propagate the erroneous idea that a private management will save the Brazilian’s health. However we observe that with the entry of privatization, there is a greater concern for profit, strengthening the hospital medical complex at the expense of the health of the population, giving priority numbers and no real improvement. This privatization still tends to further tip the balance taken each time the access of people who cannot pay. Thus, inequality of access is not due to scrapping but the various political forces that tend to keep their privileges and remove the right -in particular the right to health and education-of the less fortunate. We see the least favored part of the society faces with their increasingly limited access, breaking the logic of equity and universality of the health system and the bourgeoisie keeping the privilege and right to health as it holds the capital to acquire it. As we witness twists and turns in Brazilian politics, the poor die at the hospital door without being able to access it.

The class reconciliation policy adopted by the Workers' Par t y over the years, with the “apassivamento unions”, social movements and large student movement are reflected in the current scenario, where the guidelines that arise in the government opposition camp can mobilize many sectors of society, especially the middle class. Scary is also the rise of fascist character movements in recent times, which seriously undermines the democratic rule of law. It is also important to note that corruption - the main agenda of these manifestations - is part of the system structure in which we operate, it is mainly through it, that large corporations and companies take control over the state, literally buying the laws and political projects in the country to meet their needs and not the demands of the population. In addition to not condone corruption is a need of change on the structural Brazilian political system we have, in fact, the end of this matter. In this sense, it is important to have population’s support on the investigation and punishment of all those who are found guilty, and the defense that investigations should not be selective and respect the Brazilian legal system.

References:

In this context it is necessary to keep up against any precariousness project of public health and education, as well as any attack on human rights and social rights. The uncompromising defense of democracy must permeate from the daily habits to our foreign policy performance.

1. Saúde: por que reverter a privatização – Revista Carta Capital – Lilian Terra: http://www.cartacapital.com.br/blogs/outras-palavras/saude-por-quereverter-a-privatizacao-2346.html 2. Vídeo Marcelo Freixo sobre a conjutura: Venho aqui para dialogar com a dúvida, com a angústia e fazer um apelo ao bom senso': https:// www.facebook.com/MarceloFreixoPsol/videos/1132568560116732/ 3. A vaca tosse vai pro brejo e pode atolar o sus - Ana Maria Costa e José Antônio Sestelo - cebes - Publicado originalmente no Viomundo 4. O governo está encurralado e dificilmente sairá do atoleiro em que se meteu desde o começo- Gabriel Brito – Correio da Cidadania: http:// c o r r e i o c i d a d a n i a . c o m . b r / i n d e x . p h p ? option=com_content&view=article&id=11494:2016-03-15-01-16-53&catid=3 4:manchetea 5.Lula Virou um lobista. E ponto. – Bernardo Pilotto – Gazeta do Povo http://www.gazetadopovo.com.br/opiniao/artigos/lula-virou-um-lobista-eponto-a9bauqhmouh20flvsh1hnys6b?ref=aba-ultima 6. United Nation Humans Right - Press briefing notes on Brazil http:// w w w. o h c h r. o r g / E N / N e w s E v e n t s / Pa g e s / D i s p l a y N e w s . a s p x ? NewsID=18510&LangID=E 7. Vídeo de Wagner Moura sobre o momento: https://www.facebook.com/oficialwagnermoura/videos/467693933436268/ 8. Porque eu continuo não indo a rua – Tayná Leite: h t t p : / / w w w. b r a s i l p o s t . c o m . b r / t a y n a - l e i t e / p o rq u e - n a o - vo u manifestacoes_b_9438102.html

Social movement building for Health Equity. Perspectives and Suggestion of action for improvement of health policy to rural areas Escobar Germán Ángel Emanuel IFMSA-Argentina

Social movements emerged in an effort to forge greater social justice and to enhance living conditions from a liberating perspective. These are daily confronted with inequality of power in claim for dignity, freedom, life, safety, health, education, free speech. Some have emerged defending the interests of workers, in order to transform the current model of inequity. Other for the protection of the environment and questioning of the development model. Health became one of the principal goals due that Health disparities have their roots in social determinants. Social actors are agents of change needed and not exclusive, it is this social revolution that leaves out gender discrimination between men and women. Internally in these movements, seek the horizontality of debate and reflection of democracy in decisions. It’s essential that a person is formed a general idea of the world with an open mind. The forms of intervention in the social movement does not really fit a concerted logic breaks the "traditional" or institutionalized "when manifest their demands. The actions transgresses the established by legal regulations by taking measures such as blocking access to government institutions, roadblocks and routes. Movements is not a spontaneous creation, is an emerging of integral Crisis. Many social manifestations in America have occurred, demanding improvements in health, education and decent work.

Argentineans lost their jobs, around large cities began to settle in poorer areas (vulnerable sectors of poverty, slums) with loss of social rights. The state proposed only palliative food policies. Around the year 2000 health and public education collapsed. This point is crucial as a manifestation of the depth of the social crisis. Schools and hospitals were (and still remain) a daily sample of endless suffering. Health inequity among vulnerable groups and their connection to the emerging global environmental problems Currently socio-environmental movements arise due to problematic health related the indiscriminate spraying of crops, that is implicitly ignoring the basic needs of the inhabitants of the region fumigated and repeated demands for a solution alternative and food sovereignty. Health equity is an economic issue as well as a social justice issue. The demands around the right to health have taken center stage, contributing to the redefinition of social rights as enforceable rights. Considering the right to health as one of the social values that we try to promote in the analysis of the political and economic decisions made in our society, in Argentina, emerges a University Network for Environment and Health (REDUAS) coordinated between academic professionals, academics, scientists, members of teams of human health at different levels and other researchers.

Health policy will not be effective if data essential in rural areas are ignored Health inequities are unfair, avoidable and remediable differences in health status between countries and The scarcity of social resources by some groups of between different groups of people within the same population generates a exposure to higher risks for country. The reduction of inequities in health requires health, compared with other population groups. In 21 joint work between the health and other government 90´ after a economic crisis meant many sectors that have influence on the social determinants

of health.

The knowledge derived from rural census would help certainly to put an end to obstacles in the way of social and health welfare. Must be strengthen the methodological approaches eg through GIS for monitoring inequalities and inequities in health, description of health status for epidemiological analysis and impact assessment of population interventions through multidisciplinary networks Collaborators Groups .

We need to expand the dissemination of knowledge of the scientific data available, and often invisible; contribute to the generation of new experimental and observational data and information from our population; and strengthen the voice of health teams, researchers and people in general affected by environmental insults generated by aggressive production practices.

It is necessary to have a database that considers actual statistical data, and a system in health centers of low complexity, including first aid rooms because census data do not always give people a lot of people. Considering the existence of other organizations that have the same goal, we must build alliances and social networks that articulate the different social actors interested in Health. We must be find a way to work together and empower ourselves. In t h i s w a y w i l l c a n a c h i e v e s i g n i fi c a n t accomplishments to health equity in the Americas.

We must recognize that the statistics are the fundamental basis to take any political, social, health decision. Measurement of population, differentiated ethnographically in national censuses, is a complex process, for all its methodological requirements. But it is a challenge that implies considering factors of a social reality that is obviously more complex. In many countries there is an absolute inaccuracy. It´s relevant the lack of accurate information by which makes it impossible conduct serious investigations, leading that programs and health campaigns in certain cases is performed blindly. The lack of certain data allows any number is issued, that is why are necessary, advocate for the results of a census and a cadastre made correctly. The system of traditional medicine community has survived with the services of Shamans, healers, bonesetters, the elderly, midwives, so in many cases, there is no data of people who come to them.

References: 1-Juárez-Ramírez C, Márquez-Serrano M, Salgado de Snyder N, PelcastreVillafuerte BE, Ruelas-González MG, Reyes-Morales H. La desigualdad en salud de grupos vulnerables de México: adultos mayores, indígenas y migrantes. Rev Panam Salud Publica. 2014;35(4):284–90. 2-REDUAS http://www.reduas.com.ar/ 3- World Health Organization (WHO). Closing the health equity gap. Policy Options and Opportunities for action. NLM classification: WA 525. Geneva: WHO; 2013. 4-Organización Panamericana de la Salud.Intersectorialidad y equidad en salud en América Latina: una aproximación analítica. Washington, DC : OPS, 2015.

i.e. has not been quantified statistically, but most of the population has used for many years, traditional medicines and practices for the recovery of his health, which is still an everyday practice in the absence of services and to the abuse of costs for access to Western forms of healing. So there are no statistical records of the coverage provided by the NGOs. Any health policy will not be effective if data essential in rural areas are ignored. People with low socioeconomic status or that living in rural areas suffer from inequities in health and healthcare lead to lower quality care and worse health outcomes associated with higher mortality and morbidity, and treatments that differ greatly.

SCOPH STANDING COMMITTEE ON PUBLIC HEALTH

SCOPH Regional assistant message

Aline D. Khatchikian SCOPH RA

Dear Americas, The Standing Committee on Public Health (SCOPH) brings together medical students from 21 different associations in 19 countries in the Americas. It provides a platform for sharing ideas and developing skills in public health. What exactly is public health? It’s the study of health on a population basis. Instead of only treating one person, you can impact a whole society by the actions you take. It can be a variety of things, from advocating for healthy food in cafeterias, to encouraging students to bike to school, to developing community outreach programs to lower the rate of diabetes. Public health focuses on the promotion of health and the prevention of disease. In fact, we often call ourselves SCOPHeroes because we are the secret superheroes of our health systems. We help thousands of people who will probably never meet us, but that benefit from our efforts of making the healthy choices the easy ones. Encouraging students to get involved early in their medical careers is one of the greatest things IFMSA has to offer. As SCOPHians, we take the time to evaluate the social determinants of health of our populations. We analyse why people are getting sick, and work towards policy changes to prevent future health issues. Our SCOPH campaigns are very diverse since public health issues change greatly from one city to another. We often tackle issues related to non-communicable diseases (hypertension, obesity), communicable diseases (dengue, tuberculosis), mental health, global health (climate change) and universal health coverage, amongst others. It has amazed me how dedicated the Americas’ medical students are to SCOPH campaigns. The Regional Meeting 2016 in Uruguay allowed us to meet and discuss about advocacy, climate change and universal health coverage. It also allowed us to brainstorm on other public health issues and motivated us to continue our hard work. I am very honoured to be the America’s SCOPH Regional Assistant. It was only one year ago that I joined IFMSA-Québec as a motivated local officer of public health. I was lucky enough to attend the RM2015 in Colombia, the SRT2015 in Mexico, the AM2015 in Macedonia and the 54th Directing Council of the PAHO in Washington, D.C. I gained knowledge and experience that I now gladly share with our Region. I therefore encourage you to keep doing what you love, as you will also inspire others to do the same. Together, we can make a difference. Together, we can change the world. Aline D. Khatchikian SCOPH RA Americas

Public health and social media Juan Manuel Jaramillo Mejia ASCEMCOL â&#x20AC;&#x201C; Colombia

Digital media is now a powerful tool to share information quickly and effectively. In Colombia, we have therefore begun to develop public health campaigns virtually, with social networks (Facebook, Whatsapp and Instagram) and through interventions with communities, students, and populations at risk.

As for the activities related to cancer, we made several symposiums in different cities around the country, plus a virtual campaign, in order to inform people about the topic. For this campaign and the one about TB, we designed cover photos for Facebook. LPOs changed their cover photos as a symbol of support for cancer and TB patients.

In the first three months of 2016, we organized three main activities linked to disease prevention. We worked on preventing leprosy transmission (January), reducing the stigma related to cancer patients and the gap between them and health workers (February), and preventing tuberculosis transmission in health care workers (March). These activities were developed with the help of the people in streets, universities and social networks. Our principal objective was to create a greater impact in the population and increase the number of people who would see the information.

According to me, and to looking back at the success of our campaigns, it is vital that all activities have a social network component. Today, people spend a lot of their time connected to the Internet, and they get a lot of their information through social media. ASCEMCOL is positive that social media is a key factor for successful health promotion and disease prevention. All of our public health activities will have a virtual component, in order to spread the message to more people.

We decided to start with a virtual campaign to prevent leprosy. Even if itâ&#x20AC;&#x2122;s not a highly prevalent disease in our country, there are new cases every year. It is therefore important to detect symptoms and treat them early. Our virtual campaign was a success and had an impact on more than 2500 people (national and international).

Balance… It that Possible? Angelića Baker JAMSA-Jamaica

This is the question on the lips of many medical students especially those who come directly from High School. Medical school can be quite challenging with adjustments such as living on your own, not having a teacher demanding assignments but a lecturer who facilitates learning for an hour then leaves, and the quantity of work in and of itself. Gone are the days of studying the night before an exam and doing well, it is an entirely new ball game. However, is it possible to be involved in co-curricular activities and manage the vast amount of academic work at the same time? SCOPH responded with a resounding YES! JAMSA-SCOPH under the theme, “Believe the Goal, Achieve the Dream, It’s all Possible” invited Douglas Fletcher, a fourth year medical student, Hall Chairperson and student athlete and Jonathan Mitchell, a final year student, basketball player and a popular disc jockey to share advice on how to strike this balance. Here are a few tips they shared: · Prioritising: Time management isn't the most crucial aspect to balance. It's nice to have, but prioritising is tantamount. If you know you have a certain amount of work to do you may just have to pass up on playing that football game or partying at the Fiction Night Club this week. (Douglas) De-stress: Find as many things outside of school that you enjoy doing and use them as avenues to relieve stress on a regular basis as your mental health is very important. (Jonathan) · Find what works for you: Not because it works for someone else means it will work for you. Know 26 how many activities you are able to manage and

when studying find a place that is conducive and take short breaks in between. If you cannot get work done in the library, DO NOT TRY TO! Maybe a tree outside is where you need to be. (Douglas) · Efficiency: Look inward to find out what it is that you need to do to be where you want to be academically and figure out the most efficient way to get it done. If you need eight hours of sleep to perform at maximum efficiency then that is what you need to do. Be honest with yourself and do not sell yourself short. (Jonathan) The balance with academic and co-curricular activities is possible and it will not only enhance your resume but add to your own personal development. The journey to the end of medical school may be a long one but being involved in various activities, having a social life, staying in contact with family and friends and enjoying experiences outside the realms of Anatomy and Pharmacology are all necessary for the journey to be an exciting and healthy one. Strike that balance, it is possible. Orange hugs

Public health and social media Jodell SutherlandSievwright and Angelica Baker Jamsa-Jamaica

With the H1N1 virus making headlines and varicella outbreaks last year, SCOPH saw it fit to have an informative session on “The Importance of Vaccinations”. Over the years we have heard of parents preventing their children from getting vaccines and so sharing information on the mechanism behind vaccines and how they help to prevent death will help to clear doubts that may linger. We have come a long way in our fight against many fatal diseases such as polio and measles and vaccines have helped us to win these battles. Vaccines indeed are extremely important. As medical doctors in the making, it is important for us to protect ourselves against possible infections that can be life threatening so we also should ensure we are fully vaccinated and acquire the necessary ones as time goes by. A vaccine is a product that produces immunity from a disease and can be administered through needle injections, by mouth, or by aerosol. The injection of a killed or weakened organism that produces immunity in the body against that organism is termed vaccination and immunization is the process by which a person or animal becomes protected from a disease. Vaccines cause immunization, and there are also some diseases that cause immunization after an individual recovers from the disease. The session was conducted by Nurse Wallace, a Public Health Nurse at the University Hospital of the West Indies. She explained to the group of students what vaccination entailed, while incorporating data specific to Jamaica and other countries. The information was concerned mainly with the diseases for which specific regions are notorious for having. As integration of Jamaica with 27 the other world nations increases, there are more

diseases being introduced to the population. The group was further informed of the need for storage of the vials between -8° Celsius to 15° Celsius, specific to the type of vaccine. Vaccines may be alive or killed, in a powdered form in need of mixing or in solution. Age-related in terms of at birth to various ages and nation-specific vaccination requirements were explained. With the current outbreak of H1N1 Virus in the Caribbean, this workshop could not have come at a more appropriate time. One participant stated, “I am going to get my H1N1 vaccine tomorrow”, as the University of the West Indies advertised the availability of the H1N1 vaccine for a reasonable cost. Vaccines have played an important role in health, immigration and the economy of every country. Having a healthy population results in a healthy workforce to support the country’s development. As budding practitioners we also need to be aware of the laws References

http://www.vaccines.gov/basics/

Health concept as biopsychosocial: Limitations and Overcoming Roberta Silva de Paola, Vinicius Neves de Jesus Rodrigues DENEM-Brazil

We have debated the concept of health for a long period of time. Many great minds such as Hippocrates have also reflected on the topic (Buck et al, 1988). Even if we want to reach a consensus, it is clear that health is a very subjective concept and that it is difficult to find uniformity in definitions. Family medicine today works with the concept of "biopsychosocial welfare." We find that this definition can be sometimes a barrier to explain the disease process for a lot of people living in vulnerable social spheres, creating a necessity to rediscuss it. (Gusso 2012) Several authors show that much of what we have as a biological and psychological effects of the disease has a cause: social situation. Many factors are manifested in the same way among people, but the poor, for example, especially where there is greater social inequality, get sick at a higher rate. Illiterate sicken more than literate, as well as lowincome people (Silva, 2014; dene, 2013; Barata, 2009 and 2001) or african descendant communities compared to caucasians (Barata, 2009 and 2001). Work is an important factor of illness, especially amongst dissatisfied professionals and the unemployed. Working in a situation of instability or severe supervision, as well as whose working with goals and deadlines are mechanisms that can expose individuals from certain diseases. The biopsychosocial concept states if there were a problem in health it can be for three causes. Some are biological, other psychological cause, and other social causes but these causes are on the same level of importance. After literature review, it is c l e a r, h owe ve r, t h a t t h e b i o l o gi c a l a n d psychological repercussions are reflections of demonstrations and social unrest, and thus socially determined. Meaning that social characteristics are

actually the causal caucus for the other two factors of the original tripod. This concept of heath is called social determination of the health-disease process. Health care is only one factor in the health-disease process. It is clear that beyond of a universal service, we need to transform the social foundations of our society. If we reflect how much work, food, housing, income, the process of consciousness, relations between people interfere in the health-disease, etc., we will realize how the conquest of autonomy and emancipation of the way and style of life is essential to transform the health status of population. It’s necessary to understand that with this theory the study of social determinants of health must involve the characterization of health and disease by phenomena that are proper to man's ways of living, the way of working and enjoying life, involving where they live and their position in society. Therefore, we need to understanding the social determination as a central risk factor for illness and guide our education and medical practices from this concept that expands the References -BARATA, RB. Como e por que as desigualdades sociais fazem mal à saúde? Rio de Janeiro: Editora Fiocruz; 2009. 120 p. -BARATA, RB. Iniquidade e Saúde: a determinação social do processo saúde-doença. REVISTA USP, São Paulo, n.51, p. 138-145, setembro/ novembro 2001 -BUCK, C. et al. (Ed.). El desafío de la epidemiología. Washington DC: Organización Panamericana de la Salud, 1988, p. 18-19. -CHAVES, DB. Et al. Fatores de risco para hipertensão arterial: investigação em motoristas e cobradores de ônibus. Rev. enferm. UERJ, Rio de Janeiro, 2008 jul/set; 16(3):370-6 -DENEM. Determinação Social do Processo Saúde-Doença. Revista da Coordenação de Educação em Saúde. Produção Independente, nº1, 2013. -GUSSO, GDF.; LOPES, JMC. Tratado de Medicina de Família e Comunidade – Princípios, Formação e Pratica. Porto Alegre: ARTMED, 2012, 2222p. -VIANA, PVS. Tuberculose no Brasil: Uma análise dos dados de notificação, segundo macroregião e raça / cor, para o período 2008-2011. Rio de 28 Janeiro; s.n; 2014. 110 p. tab, graf.Tese em Português | LILACS | ID: lil-714013

“Niño manuelito”, Cusco-Peru Angela Mariela López Aranzábal, APEMH-Perú

Peru, more specifically, Cusco, the region where I live, is an area of the world that has a lot of social inequality and serious inequities in health conditions and access to health services. Although the government has developed programs that seek to address these issues, they are inefficient in addressing the growing disparities in living and health conditions of many social groups. In addition, many regions are difficult to access in Cusco, which makes the challenge even greater. APEMH and SCOPH ae well aware of these problems. We work not only in prevention and promotion of health in the general population, but also on projects that aim to combat inequalities and inequities in health. One of these projects is carried out annually during the month of December at APEMH’s Andean University of Cusco. It is called "Niño Manuelito" and it’s mission is to bring joy to children in financial difficult. We brighten up their day by organizing a party with gifts and by distributing the traditional chocolate of the season. We also provide a basic medical exam to all the children, and of ten, to their accompanying family members. With this project, we contribute, on a small scale, to bettering the health of these people who need us. Although we are not yet qualified professionals, we are students who aim to make a better world for all.

SCOPH in the Americas

Public health in Latin America, especially in El Salvador, is a key tool in eradicating diseases. El Salvador has a warm climate which is linked to a high prevalence of viral diseases like chikungunya, dengue and zika. Even though specialists and the government try to promote health, there is still a lot of work that needs to be done in education in order to properly inform the population about their health issues. SCOPH in El Salvador organizes local projects geared towards mainly students, both in medicine and in other programs, in order to invest in the professionals of tomorrow. We created the “Stop smoke” campaign to prevent smoking in medical students. We also celebrate World Cancer Day and highlight the importance of water through our “I protect water” project. Our “Know your numbers” project gives importance to the role of prevention and early detection of non-communicable diseases. We take the blood pressure, glucose and BMI of our communities to assess their risk factors for major diseases. We have many local initiatives, but we also organize internationally recognized projects, like Teddy Bear Hospital. It focuses on a children between the ages of 3-7 years old, in different places like schools, orphanages, hospitals and poor or low-income communities. The purpose of this project is to show kids the role of doctors and other health personnel in a new, creative and funny way. We make different stations like pharmacy, X-Rays, consults and surgery, and we use teddy bears as patients. All of the children take on the role of doctors. The purpose of this project is to allow the kids to understand that doctors are people who protect their health, and to promote the importance of 30 preventing disease.

Natalia María Barriere García, Jessica Vanessa Ramírez Olivo, Katherine Elizabeth Lainez Pérez IFMSA-El Salvador Finally, our campaigns on hypertension prevention, NCD risk factors, water conservation, and health promotion are ways that SCOPH medical students in El Salvador (AEMES) make a change in the community.

Commemorative activity World Down Syndrome Day “Don’t let the features of my face stop you from seeing my being" Ana Patricia Gómez, Lilian Teresa Pimentel ODEM-Dominican Republic

On March 18, 2016, the Committee on Public Health (SCOPH) that aims to sensitize and train medical student on the concept of health, while projects are developed to promote health and prevent disease both at Community level as social, belonging to the Dominican Organization of Medical Students (ODEM), I hold a commemorative activity to March 21 World Day Syndrome Down which is caused by an error in cell division called 'nondisjunction.'

Globally children with Down syndrome are integrating them through a comprehensive development: at school, in the family, in society, socialization, development opportunities and social skills. Dominican Republic is within this challenge, seek equitable development of children with Down syndrome and will do with the new public policies on disability. This activity was attended by 13 members of SCOPH belonging to the Universidad Iberoamericana (UNIBE), University Pedro Henriquez Urena (UNPHU) and the faculty of medicine at the University O & M (O & Med). During our visit, we teach them to children brief talks about eating healthy with the help of a food pyramid. Then the children used tempera paint and paper to a "healthy food". Finally, we headed to the recreation area in the center, where we played with the kids and we said goodbye to them.

Nondisjunction results in an embryo with three copies of chromosome 21 instead of the usual two. Before or at conception, a pair of 21 chromosomes in the sperm or egg can not be separated. As the embryo develops, the extra chromosome is replicated in every cell of the body. This type of Down syndrome, which represents 95% of cases, is called trisomy 21, with this celebration, the General Assembly wants to increase public awareness of the issue and recall the inherent dignity, worth and valuable contributions people with intellectual disabilities as promoters of well - being and diversity of their communities.

During the meeting were highly sensitive to the potential, the affection of these children, which explains that his being and personhood imposed break down barriers and stigma felt by their genetic characteristics exclusion of unrelated companies and dehumanized. Hence the “Don’t let the features of my face stop you from seeing my being”'.

Using as main theme "Let the features of my face does not prevent you see my being" held an activity with the Dominican Association of Down Syndrome (ADOSID) that seeks to promote the education of people with Down syndrome and their families, to develop their full potential and skills that enable their integration into society, in which SCOPH members had the opportunity to share with padecientes Down Syndrome children.

It was a pleasant experience for ODEM shares with these children, their reality and parpar your needs. We hope that for the next few years every family with children with Down syndrome find those opportunities, institutional and education for these children to have access to development opportunities and demonstrate its potential as a person.

Popular Pharmacies Tamara Bustos, Jorge Gonzalez IFMSA-Chile

This story is an example about the root of the public health problems of our country, Americas region and maybe the world. Its protagonists are common people as all of us, tired of injustice, but as nonconformist as dreamers. It is a story that has just begun to be written, and maybe was started in a small place by anonymous persons; but this inspiration they gave to us, left us thinking on how many changes could we achieve to improve the health system and the quality of life of those who need it the most. Where there's a will there's a way.

In response to these facts, desperate neighbours and municipality workers decided to take the other hand of law: it is the responsibility of the municipality to safeguard the community's health and welfare, but they cannot if they are not able to afford those drugs neither. And they started to create non-profit pharmacies called "popular pharmacies"; popular because it comes from and to population. This project manages direct purchase of medicines to national laboratories and also imports from abroad, obtaining drugs at much less cost than buying them to the colluded pharmacies and makes a kind of municipal delivery service of medication. Of course they are having problems!, a lot of lawsuits, economical pressure and barriers; but this staff will not make them stop. This system has been replied in 4 communes in only a few months and it is not planning to stop.

The struggle for equitable and universal access to health has been present in Chile since the early twentieth century, because although progress has allowed to reach an important part of the population that was previously excluded, many lacks are patent and remain in the public system. One of the main concerns we always have is access; In this system of huge social inequities and a gigantic to medical attention, to exams and even more historical debt in matter to public health, this type of devoid of dignity, access to medication; because it actions funnels public policies towards the people, and does not matter how much effort you did to find a gives us back the hope to continue building a better diagnosis and propose of treatment, you will never society. know if your patient will be healed (Or know they will not) of something easily treated with drugs, but they cannot achieve secondary to its unaffordable commercial value driven by market logic and not by the social interest or need. This concept, completely legal, means to make a scale will between need and business and allows pharmacies to decide a price to priceless goods, such as health and life. Having this deficient laws permitted the major pharmacies of the country collide to raise drug prices altogether, a situation in which they were found guilty in January 2012, creating a stir nationwide, and even there was an economic punishment, it did not create a change, and we are still seeing this problem anyway, everyday. 32

Don’t forget about me Júlia Fernandes Aguiar IFMSA-Brazil

In the last few decades, studies have shown an incessant growth of Brazil’s elderly population. Projections evidence that in the year 2020, 30.9 million Brazilians will be over 60. Therefore, the increase of health issues that come along with age is becoming more notable. Among the illnesses, Alzheimer's is a particularly worrying one. Specially when combined with late diagnosis and poor care. Accordingly to the World Health Organization (WHO), Alzheimer’s disease is the most common cause of dementia, representing 60-70% of all cases. As a public health problem, this pathology doesn’t only affect the life of the ailing. The whole family is forced to a change of habits in order to give the right care and support the sick person needs.

Later it was revealed that, in fact, you do not know each other, but the confusion that he/she felt was the same experienced by a patient with early Alzheimer's. The next part occurred in seven different days in resting homes. During each visit, we would develop several activities with the elders: play games, guitar, sing, dance and simply chat with them about anything they would like to. The experience was, somehow, life changing. Besides that, we conferenced with the caregivers in order to give us more understanding of patients’ situations and of how difficult it is to deal with them in a daily basis. The last stage was a round table discussion with the presence of a geriatric and a general doctor, who debated about Alzheimer’s disease and its repercussions to patients and their families. Results and feedback received were very satisfactory. The population approached was amazed at how this illness affect people’s life. This kind of reception evidenced the lack of knowledge about dementia in Brazil, and how simply this subject could be inserted on society. The project still reinforced the commitment of the students with the patient’s global care, learning to focus not only in the biological, but in the psychosocial aspects of the disease.

Although some people know about this disease, most of them lack understanding what are the initial symptoms and can't distinguish physiological aging from what is pathologic. Concerned about this scenario, IFMSA Brazil's local committee at the Faculdades Integradas Pitágoras de Montes Claros (FIP-Moc) held the project "Não se esqueça de mim"(Don't forget about me). It was composed by four stages: capacity building, population awareness, Alzheimer's care and the final discussion with a round table. The first part was developed with the exhibition and posterior References analysis of "Still Alice". It’s a movie that portraits the 1-World Health Organization. Rates of demência. 2015. http:// www.who.int/mediacentre/factsheets/fs362/en/ struggle of a university teacher that recently 2-Instituto Brasileiro de Geografia e Estatística. Síntese de Indicadores discovered she has Alzheimer's and the effects of Sociais Uma Análise das Condições de Vida da População Brasileira. Rio de this condition to her social life, especially to her Janeiro: IBGE. 2012. closest relationships. Afterwards, the students 3-Nitrini, R; Caramelli, P; Herrera, JR, et al. Incidence of dementia in a community-dwelling brazilian population. Alzheimer Dis. Assoc. Disord., v. argued about the impact of this disease on the 18, n 4, p. 241-6, 2004. patients and their families. The second stage was guided by a workshop made before the approach. In which, it was taught how to pretend to know a 33 strange and make them believe that they know you

Multiple reason to know, many reasons to inform

Information saves lives: Multiple Sclerosis (MS) is a disease found in every region of the world, although there are substantial inequalities in the availability of information resources. The difficulty in disseminating information about the disease hinders access of people to specialized professionals and treatments, allowing us to imply that probably hundreds of thousands of people remain undiagnosed.

Célia Sarah Gava de Almeida Jorge, Helio Lopes Neto, Elouise Zwirtes Frare, Ana Heloísa Coronado Berg , IFMSA-Brazil in MS, if they knew a carrier of the disease, if they were aware of the existence of ALPEM and its support to carriers of MS, among others. At last, a flyer was given to each one of the respondents in order to provide complementary information, clarify doubts, give contact instructions and expand the campaign’s reach.

In short, MS is an inflammatory and degenerative disease, explained by the destruction of the myelin - fatty white substance that surrounds the axons in the central nervous system - promoting a wide spectrum of symptoms, which may mimic other CNS (Central Nervous System) diseases.

The interviews results showed that around 50% of the respondents had familiarization with the disease, knowing its key aspects. There is still much to be done. The Atlas of MS, the most extensive worldwide study of MS, points ten principles to promote the quality of life for people with MS. Between them, the principle that these people have access to care doctors, treatments and therapies suited to their needs. As students, we can help by providing information to our fellow, teachers and community.

In order to raise awareness and understanding of MS among the general public and health care professionals, a group of students of IFMSA Brazil in association with ALPEM (Association of Patients With Multiple Sclerosis of Londrina) promoted a campaign called "Multiple Sclerosis from the perspective of the doctor and the patient", on August 30th of 2015, Brazil’s National MS Awareness Day. The meeting with the organization’s president – that has MS since she was about 20 years old – showed us the reality of the disease, its lack of information and support from the government and the need for health students to lend a hand. It is nearly impossible to reach patients without an organization like that; and yet one in five countries has no organization providing support to them [1]. During the campaign, were addressed 262 people directly. About 20 students interviewed people passing by the street with a questionnaire containing questions about previous knowledge in

As IFMSA coordinators and trainees, we could develop campaigns and projects to ensure that people with such disabilities get proper care and attention. More than making a difference on MS, our campaign proved that “Think Global, Act Local” makes perfect sense, and maybe a 3 minute speech does have a bigger impact than one can imagine. References 1-Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity 2-Paul Browne, PhD, Dhia Chandraratna, PhD, Ceri Angood, MPH, Helen Tremlett, PhD, Chris Baker, MPH, Bruce V. Taylor, MD and Alan J. Thompson, MD, FRCP 3-Neurology September 9, 2014 vol. 83 no. 11 1022-1024

Symposium “Zika and microcephaly: understanding the relation”. A discussion about the virus and the infection consequences. Manuela Nascimento de Lemos, Anna Carolinne Corrêa dos Santos, Nathalie Abdallah Zahalan. IFMSA-Brazil

Discussions around the Zika virus, an arbovirus transmitted by the Aedes aegypti mosquito, became stronger when neonatologists of some Brazilian states have linked the large number of cases of babies born with microcephaly to Zika virus maternal infection during pregnancy. The Oficial Epidemiological Notes of microcephaly released by the Ministry of Health on 23 February 2016, showed that there were 583 confirmed cases of microcephaly caused by congenital infection from October 2015 until February 2016. In this context, the UFPA IFMSA Brazil committee promoted "Symposium Zika and microcephaly: Understanding the relation" which happened on March 17, 2016, and sought to educate students and health professionals about the virus and possible relations to this defective development of children's nervous system, about the care needed during a pregnancy from infected mother and the main consequences for the health of the newborn of this mother. The symposium featured a set of three lectures given by a gynecologist-obstetrician, one pediatric neurologist and a infectologist, updated on the subject and involved in researches related to the theme. They spoke on multiprofessional approach to the pregnant infected by Zika and the newly born with microcephaly. The infectologist explained about "Zika virus: what is known so far, its transmitter and aspects of the associated disease," while the gynecologist discussed about "Infection Impacts by Zika in pregnancy" and the neuropediatrician, talked about "Microcephaly caused by viruses Zika: consequences for the child's development”. The speakers showed to the participants what is new on Zika virus scientific world literature, the transmission of the virus, mainly risks offered to the

the fetus and ways to prevent it. Each presentation was placed in an hour, or less, and after the exposition, the ones who wanted, were allowed to ask questions. About 100 people attended the event - including academics, medical residents, nurses and other health professionals, whom heard attentive to updates on the management of these patients. Further, at the end, an evaluation questionnaire of the event was applied to participants who willing to carry out the assessment. It obtained excellent feedback from them, which of 49% marked "good" on the item "quality of the symposium lectures," while 51% said the symposium was "excellent." As the organization promoted by members of the LC UFPA IFMSA Brazil, 57% described as excellent. About the expectations, 98% of participants had t h e i r e x p e c t a t i o n s m e t w i t h t h e e ve n t , demonstrating that the purpose of notify and educate health professionals and students was reached.

SCOPE& SCORE STANDING COMMITTEE ON PROFESSIONAL AND RESEARCH EXCHANGES

SCOPE and SCORE Regional assistants message

Rodrigo Roa Mauro Camacho SCOPE RA and SCORE RA Dearest Americas Family, We are extremely proud to introduce you Exchanges Section in the Americas Heartbeat. The first standing committee within IFMSA was the Standing Committee on Professional Exchange (SCOPE) in 1951. It started small, but since then has grown into one of the most largest student-run exchange program in the world, with more than 1.5 million medical students from 98 National Member Organizations participating until today. The SCOPE exchange program is a quality educational and cultural experience organized entirely by medical students with the help of their medical faculties. As for the Standing Committee on Research Exchange (SCORE), it was founded in 1991 and today is present in 67 National Member Organizations. It aims to offer the opportunity for medical students to experience research and diversity in different countries while developing skilled researchers and culturally sensitive students. Working as SCOPE and SCORE Regional Assistants for the Americas Region, we canâ&#x20AC;&#x2122;t hide our happiness when it comes to this term. It has been the best period of our IFMSA lives so far and since the beginning of the term in October 2015, together with the SCOPE and SCORE International Teams we keep working closely to our Annual Working Plan to make sure that in the end of the term we have achieved all our goals. A lot has been done, but we still have work to do. In this section, you will read the best exchange articles we received from our members. This engaging and inspiring section serve as a space for medical students around the world to share their experiences, projects, ideas, initiatives and promote their country/NMO in SCOPE and SCORE. You are going to meet the exchange officers of our region, read about their experiences, their challenges, and meet their friends from every corner of the globe. Prepare yourself as you embark on journey that will take your breath away! Enjoy your reading! With love, Your favorite Exchange Regional Assistants, Mauro and Rodrigo

Ecuador, a great place for an Exchange Andrea Falconí AEMPPI Ecuador

I’ve traveled the World and although I’ve been to incredible places I can say that there is no place as unique and beautiful as my country, Ecuador. The passion I have for it has pushed me this year to make our exchanges better, turning them into a perfect opportunity for people around the world to visit, discover and fall in love with Ecuador. It is unbelievable all the work we’ve done this year regarding the exchanges. Since we gained legal recognition from the E c u a d o r i a n government, things have just kept rolling for us. From signing contracts with the most prestigious hospitals, to working vigorously to improve our Academic Quality, I can say that the exchanges from AEMPPI Ecuador are a once in a lifetime opportunity. Now, they are not only focused on fun, but are also built based on the student's objectives and expectations. As a country, we offer unique opportunities; such as helping women during labor work, or attending surgeries with nationally recognized surgeons. Our exchanges are personalized, were each tutor works with one single student, improving the learning process and skills acquisition. Since January, we’ve made hundreds of new arrangements, expecting that our exchanges will become the best in the region, and why not, the whole Federation.

he whole world. In our Amazon you can enjoy watching jaguars, play with monkeys and get to know the culture from our ancient tribes. The Andes, where our main cities are built, has beautiful landscapes that are enjoyable from each part of the city. Don’t passively watch nature go by, experience it: go hiking, biking, kayaking, and horseback riding through our volcanoes and mountains. If you are not a mountain person, we count with a unbelievable coastline, where you will swim in natural beaches and e n j oy yo u r s e l f, by learning how to surf and scuba dive. If you are lucky enough, you can even watch the spectacular humpback whale show during our summer season. The best part of it, a place that is unique in the whole world, Galapagos Islands. Heard about Darwin? Well, inspired by Galapagos, Darwin developed his Theory of Evolution and Natural Selection. This archipelago in the Pacific Ocean is filled with strangely fearless and curious animals that can’t be found anywhere else. One day you could be watching timeworn giant tortoises in the misty highlands, and the next you could be snorkeling with playful sea lions in crystalclear water. There really is nowhere else quite like it. So, what are you waiting for? When all you need is Ecuador.

Why Grenada? Husein Badani IFMSA-Grenada

Grenada is more than lounging on a beach, sipping fresh coconut water through a straw, all while carrying a glowing tan year-round. Grenada evokes the Caribbean way of life. Every August, Carnival, J’ouvert as it is known in this region, embraces the historical underlying of residents hundreds of years ago. Along with dressing up in the most intricate costumes during the street festival, soca music blares out of buses, taxis and trucks transformed into mobile concerts. All this goes on in the bustling capital city, St. George’s, which is also home to St. George’s University and the Grenada General Hospital. Each year, several students fly into Maurice Bishop Airport for an unforgettable experience. By day, they shadow physicians and by night and weekend, they explore the nooks and crannies of the island. I had the opportunity to ask former exchange students about their experiences in Grenada. Asier Bombín Martín, a student at Complutense University of Madrid in Spain, came to Grenada in August 2014 where he shadowed an orthopedic surgeon and anesthesiologist. Mihai Suceveanu from Iuliu Hatieganu University in Romania arrived for the exchange in September 2015, where he worked in Internal Medicine, as well as the ICU and Surgery wards when interclinical exams were requested. When asked what was unique about their clinical work in Grenada, Asier mentioned, “My trip to Grenada gave me a vision of what I would call ‘islander medicine,’ that was closer to the patient and more focused on a type of pathology related to the weather and fauna of the location. This concept is far from the medicine I see during my life in Madrid, as it is a city and the capital of a country like Spain, which implies a huge volume of bureaucracy and less field

work.” Mihai responded, “The great part of my clinical work was practicing medical English. Even though I am a fluent C2-level English speaker, I was not accustomed to the abbreviations and certain terminology of medical English. I found practicing medical English really useful in terms of the prospects of my career. Another thing that I liked in Grenada, which would probably be appealing to most students from western countries, is the chance to do hands-on stuff like taking blood or helping the medical team perform different small procedures.” St. George’s University is home to both a medical and veterinary school with a welcoming group of students from around the world. One of the activities that both Asier and Mihai thoroughly enjoyed was the hiking event organized through the Grenada Hash House Harriers. Mihai participated in a Hash at the nearby Carriacou Island where he raced to beaches and ran through a tropical forest. “After the race we danced and tasted cocktails on the beach long after the sun went down.” In addition to the Hash, Mihai admitted, “Winning $20 in crab racing at a local bar was pretty fun too.” Asier reminisced on a snorkeling trip through the reefs and underwater sculpture park. He also participated in a bonfire party at Magazine Beach, which he attended with a fellow Swiss IFMSA student. After winning a limbo contest, they enjoyed their prize of a breakfast at a nearby cafe. So why come to Grenada? It offers you the chance to join a prestigious university, observe the idyllic charm of the island, and explore the many opportunities around the island. Not to mention discovering a hidden gem of the Caribbean, pristine beaches, breathtaking waterfalls, and friendly people.

39 This is Grenada.

IFMSA BRAZIL: National Social Program. Maitê Silva Martins Gadelha and Thaís Iwashita Lages IFMSA-Brazil What should we expect from the Best Exchange Program? We, as IFMSA BRAZIL, are concerned about the main points of the Exchange: Academic Quality, Intercultural sensitivity and Social program. It is very important to do the integration of international and intercultural knowledge. However, what do you expect for an amazing Social Program? IFMSA Brazil came out with the brilliant idea of giving to the incomings the best Brazilian experience of their lives and we gave it a name: The IFMSA Brazil’s BEACH Project. These name mean: "IFMSA Brazil’s Exchange Assistance on Care and Hospitality Project". Our main goal is to promote the best moments our incomings could ever imagine by taking all of them to the same city during a whole weekend. In this way, they can discover our amazing countr y and par ty simultaneously as getting to know our landscapes and our different local cultures. The medical students can also meet new people from all over the world who are doing an IFMSA Exchange in Brazil. That is one of the points that explain why the National Social Program is so important. In 2014, the host cities were Rio de Janeiro, São Paulo and Recife. However, last year we also included Belém, in the Amazon Rainforest and we raised the number of participants. The incomings were picked up in the airport and taken directly to a welcome party on Thursday. In the following days, we promoted the best travel itinerary to make them know everything in the city: Eat typical foods, get to know the native people and party a lot. In Recife, they enjoy two days in the most beautiful beaches of Brazil and a whole day dedicated to share with the incomings the brazilian40

northeastern culture. In São Paulo, the medical students could walk a lot to know our biggest and enchanted city. Rio de Janeiro was perfect to people that were interest in amazing sightseeing, as the Redeemer Christ and the Sugar Loaf, while Belém had the best Gastronomy tourism and nature nearby. At the end, all of the incomings were home by Sunday night or early Monday to avoid skipping the day at the hospital. The BEACH Project is a unique experience to show for the incomings our lovely country. We are really prepared because we want to take care of our incomings and proportionate them great moments. We all work really hard together to provide the lodgings and organize itineraries. All of this to make sure everything will be great. Every year we try to improve our program through the review of the Evaluation Forms and trying to introduce new experiences. The students do not need to worry; they will certainly have an amazing experience. We highly recommend to all incomings who want to have an incredible time and visit beautiful places to go to IFMSA BRAZIL’s BEACH PROJECT. And also encourage the other NMOs to prepare this program.

Impact of exchanges: My experience in Argentina Larry Leiva IFMSA-Peru

As many of us know, SCOPE is a platform where thousands of students go for exchanges year per year. However, have you ever thought how strong is the impact that all these new experiences have in a regular med student? During my experience as a LEO, I’d been seen many changes of perspectives on my outgoing students after going for Exchange, that made them even encourage more people to go for Exchange too. Actually, until that moment I hadn’t been in an overseas clerkship before. Then I went for it to Argentina. I’d been waiting to have this experience for so long. Once I was there I could realize the reasons of those changes on my outgoings. Living an Exchange is something complex, awesome and lifechanging. For me, going for an Exchange was educative, I had the best 170 hospital hours I could ever had in the department I like most, Abdominal-Surgery. It was freedom, be able to go anywhere I wanted after hospital or backpacking after the whole clerkship, gave me the confidence I was lacking in life and helped me to get back home with a better attitude. It was empowering, I could make my own decisions, from planning my trip to making a last-second changes in the foreign city I was in complete control of the journey. It was friend-making, I knew incredible people, really good doctors some of them, and definitely gained new perspectives on the world from the conversations I had and the meals they shared with me. And it was a reflexive time, I learnt negative stereotypes disappear when people are exposed to new cultures and places. Most of the med students have the opportunity to go for exchange throughout such this huge platform that is IFMSA, so what are you waiting for? Think about how much of an impact going for exchange could41

form, how your perspective on the world could change, or the positive changes you could take home.

Research Exchange in Santander, Spain Maitê Silva Martins Gadelha IFMSA-Brazil

N owa d ays, i t ’s k n ow n h ow i m p o r t a nt t h e internationalization of the curriculum is. However, It’s necessary more than just an international knowledge - preparing medical students who are competent to work in a global environment requires broad integration of international and intercultural perspectives throughout the medical curriculum. That is the reason I did my SCORE Exchange Program in Santander, Spain. Anatomic Dissection was my first choice because I faced some challenges in this subject in my home university and I wanted to improve my skills to excellence. I believe I was able to learn and also become an important asset for the team. The tutor patiently taught us everything we needed to know and the laboratory turned out to be our second home. While we were working in the Laboratories, we had the opportunity to ‘Job Shadow’ Doctors and see Images Diagnosis of body members we dissected in the Labs. Our research exchange gave us a great clinical perspective, which is of great importance for our future careers as Doctors. The Marqués de Valdecilla University Hospital is a fine Hospital in Spain and I had the opportunity to learn with the most professional Doctors. One of the positive sides is that for Spanish speakers, as most of students in the Americas, there’s no language barriers. Santander’s Medical students and everyone around welcomed me since the first day I arrived in the airport until the last day when I returned home. The social program was excellent and very organized. People are very kind and the city is one of the most beautiful I have ever seen. Our group was gifted to go on small trips, go out and eat at outstanding restaurants and get to know 20 other exchange42

students with different cultures and backgrounds. I was placed with 4 medical students from different countries and I can say now that they are friends to me. We had the opportunity to discuss about the medical situation of each country and understand more about global health in our different cultures. The housing accommodation was very satisfactory as well and I have no complaints about my staying there. Falling in love for this city is not hard. Everything is clean, safe, planned and they use technological skills to make our life easier. Beaches, historical museums and good restaurants are some of the many wonderful things Santander has to offer. The students that are going to Santander do not need to worry, they will certainly have an amazing experience. There are so many positive points about this Exchange Experience that I could write a book about it. The only negative thing is: The program ends. I highly recommend to all medical students who want to have an amazing experience by learning something of their interest while visiting a beautiful place to go to Santander and I hope I can go back soon to visit this lovely place!

“The Global Health Disclosure” at the Americas Regional Meeting 2016 Salvador Martínez Medina IFMSA-México

Why do you do this? This is something we often hear when are questioned about our work in IFMSA and our reasons of doing it. If you are like most of us, and you take part of this colossal federation, by reading these first two lines you might already have the answer for the first question in your mind. Well, that is the main reason why I am now writing. Steps backwards into my IFMSA pathway, I started working in SCORE as I had the idea and conception of exchanges as an amazing opportunity to develop capacities, intercultural skills and acquiring knowledge which allows medical students to become qualified physicians ready to face international health issues and with the motivation to advocate for a better health practice. As NORE, my daily duty is to work on the achievement of academic quality, to provide great experiences to our exchange students, and to seek for academic and values recognition; but it was until this past America´s Regional Meeting that I realize the missing element that I had not focused on before. If we ask the question “What does Global Health has to do within SCORE?”, at first glance the answer might seem obvious just because of the fact that by taking part on an exchange, students will have a close approach to contrasting ways of “making” medicine and international concerns of health. However introducing Global Health into SCORE concede the students the chance to learn that is not only about being aware of the situation of health issues that go beyond national barriers and strategies used by others to solve this, but to take their exchange as a holistic experience where they need to approach all the challenges involved in global health such as identifying the social determinants of health that shape the way health incurs in a certain society as43

health incurs in a certain society as well as the impact of infectious diseases, climate change and non-communicable diseases. Now, I truly believe this is a goal that could be reached with the support of many others, medical students and health workers, who, as me, have the ideal of making and innovating the learning process of exchanges. In IFMSA México we are now working on a structured project to implement it for the first time in our NMO, in order to provide the exchange students with all of the skills afore mentioned. July will be the month were this project will be out in the light, however, this is not something that can be achieved by the work of only one NMO, we need the support of all the Region. Once said that, I rise the call, to all of you, NOREs of the Americas, beloved readers to take part of the action. Find a way to implement Global Health in your exchanges, increase the Academic Quality of your programs, and give that extra value to the experience the medical students all around the world could have by taking part of SCORE Exchanges. We are in, are you?

SCORP STANDING COMMITTEE ON HUMAN RIGHTS AND PEACE

SCORP Director message

Hana Awil SCORP D

SCORP has a vision of a world where the all individuals are entitled full and equal access to their human rights, where no one is left alone in a disaster and where the entire society unite to help the most vulnerable people. Our mission in SCORP is to empower and motivate medical students to actively promote and protect human rights and peace, and to introduce the members to different forms of humanitarian action through capacity building, field project opportunities and cooperation with external organizations. It is important that we ensure to have a clear understanding of structural causes of human rights violations. By aiming at reflecting on the capacity of Human Rights instruments, by distinguishing the important from the trivial, the intentional from the circumstantial, we can take the first steps to target the structural causes of those problems. Lastly, the essence of who we are as SCORPions, are our members. The work that you do in your communities, is essential to create the positive change we want to see in the world. You as SCORPions know that passivity is anything but impartial while facing unequal forces. Thank you for questioning injustice openly and honestly. Thank you for all your efforts. Keep up the great work dear SCORPions. Let us be the change makers of today! Green Hugs! Hana Awil SCORP Director

Migrations - Towards a Better World Djamila Saad IFMSA-Québec

In 2015, after a decade of Conservative rule, Canada went in elections. In a race that was going to change the political course of the country, the emerging Liberal Party of Canada based its campaign on promises to accept 25,000 Syrian refugees by 2016, to welcome immigration and cultural diversity, to reclaim Canada’s voice in international negotiations and, in brief, to open Canada to the world again. It won by an astonishing majority. Since then, the 25,000 Syrian refugees have indeed arrived in their new Canadian homes, and Mr Prime Minister is planning to welcome 10,000 others. It has been stated that 10% of the Syrian refugees in the world have been resettled to Canada. Furthermore, a former Conservative bill that limited refugees’ access to healthcare has now been revoked by the new Party, granting once again full funding to the refugee healthcare program. IFMSA-Québec members have been captivated by this example of generosity and openness. We have started a national campaign on migrations to raise awareness on this complex issue.

-conference with a doctor working with newlyarrived refugees, a photo campaign, a screening of the documentary #MyEscape and a mural of messages of hope for incoming Syrian refugees. The campaign will be crowned by a finale event; the Global Health Colloquium on Refugees, which will take place on April 9th. Incorporating 3 speaker sessions, 6 workshops, 10 speakers and 13 participating humanitarian organizations, the Colloquium will explore the issues of migration and resettlement, history, refugee screening, mental health, infectious disease, advocacy, women's rights, law and policy, oral health and education. It will also stand as a National General Assembly, ensuring a presence of IFMSA-Québec members from all campuses. Furthermore, as attendees to the Colloquium will buy tickets, 50% of the proceeds will go either to an NGO working with refugees or to an initiative of medical students to sponsor a refugee family to come to Canada.

Wether it’s the migration of the healthcare workforce IFMSA-Quebec members have been working or of individual citizens, from the countryside to thoroughly since September to organize the urban centers or from country to country, mass National Campaign, wether on their local campuses, movements present an important challenge on on their national committee or on the specific team socioeconomic dynamics and health systems. What dedicated to the Global Health Colloquium. This roles can physicians play in the integration of campaign, more than ever, has catalyzed the migrants? Which health problems can these collaboration of the students accross different vulnerable populations face? We have tackled these campuses and committees of Québec. It has proven questions with events, workshops and conferences that medical students are indeed concerned and by that took place on all medical campuses in Quebec this issue, and are ready to join forces to tackle it. As and touched upon a range of IFMSA Standing the topic of migration will always stay relevant in the Committees. Our national and local team has shown Americas, we believe in empowering the future creativity in organizing workshops on migrants’ medical professionals to treat and advocate for mental health, discussions on pregnancy during migrants, without prejudice and with a sincere migration, a one-day symposium on disaster empathy. management in Syria and the Middle-East, a dinner- 46

Experience report first contact of medical students with Haitian immigrants

In November last year, permanent residence was granted to 43 Haitians in Brazil. The most of these immigrants entered the country across the northern border of Brazil and do not qualify for refugee status, according to the Convention Relating to the Status of Refugees (1951). Therefore, to promote an awareness of the reality of those immigrants who are living in Londrina among LC PUC students, the project "Coffee with Refugees" was created. The term "refugee" used to name the project is not accurate, however, during the program we realized this mistake. Hence, we planned actions for this public, hoping that, knowing their reality, our committee can develop important and beneficial changes to them. Aims: Obtain an overview about the lives of Haitians in Brazil in the first contact. Moreover, meet the problems faced by them in order to further intervention in the city of Londrina Experience report: The capacity for the action was realized in PUCPR Londrina, where the coordinators Graziela and Carolina presented to the committee all the information received from the Caritas Arquidiocese of Londrina, partner for the action. Therefore, there were explained for the group how the refugees made to enter in Brazil, the legal visa issues and that they were going to meet them in the school the refugees were learning portuguese. The preparation of coffee and food that we would offer was coordinators responsibility Marinez, Mariana and Lisandra. learned that even though we can sometimes differ in opinion, at the end we all have the same goal, let's work together towards the crating of a better world! They made cakes, pies, sandwiches, juices, coffee and soda. After arriving at Municipal School where they 47

Carolina Itimura Hayama, Graziela Leal Cardoso, Lisandra Leticia Palaro, Mariana de Oliveira Cotrim, Marinez Kimura Peres Silva

IFMSA-Brazil have classes, we prepared the tables with the snacks to receive them. Total they were forty refugees, most coming from the Haiti and they were divided in two classes, one formed with newcomers and other with students who speak our language well. In order to allow a greater contact, we separate ourselves to create an integration environment to make them feel comfortable. Results: The immigrants were very receptive and friendly with our project, given the language barrier, which seemed to be a problem, was overcome with good will and patience to use simpler and slower language. Af ter that conversation with them, we had a talk amongst ourselves and shared the stories that were told to us. Conclusion: At the end of the project, we had a much better understanding of their reality and difficulties in our municipality. We made a list of the main points that should be brought up within our committee and how we could develop proposals to better the quality of life of these immigrants. These proposals may be are within our reach and the IFMSA Brazil, represented by LC PUCPR Londrina.

In Paraguay the members of SCORP are happy Gonzalo DurĂŠ IFMSA Paraguay

In Paraguay the members of SCORP are happy; we are always loved and always loving. We believe in peace, we live and love the peace, but peace, like a poem, is not there ahead of itself, can't be imagined before it is made, can't be known except in the words of its making, thatâ&#x20AC;&#x2122;s why we make peace, step by step. In Paraguay SCORP we works in the biggest problematics of our society, like LGBT discrimination, violence against women, knowledge about Human Rights, children's rights and more. If you want to help us to create a better world or just need some love send me an email to: scorp@ifmsapy.org Green hugs from Paraguay!

Solidarity rain Ana Luiza de Oliveira Queiroz Teófilo, Lurian Rei Caetano Lima, Ámina Muhamad Mota Mustafa, Eduarda Vitoria Souza Matos IFMSA-Brazil

Human rights involves basic questions that determine dignity and quality of life. These are interdependent and interconnected factors and the absence of any of these questions influences the well-being of the individual. What would be the health but the complete physical well-being, social and psychological? Based on this principle, ensure the health of the population, goes far beyond providing medical and hospital proper care and treatment of diseases. The universal declaration of human rights and the Brazilian federal constitution determine how inviolable right to liberty, the right to health, dwelling , safety and education. The IFMSA since its holistic character, must act in each of these aspects to achieve the main objective which is to ensure the individual and collec tive health of their communities, thinking globally and acting locally. The year 2016 began with tragic moments involving families who lost their homes in floods caused by heavy rainfall in Goiania. The human rights and peace committee sensitized with the situation of more than two hundred families affected and decided to intervene in order to help these families rebuild their lives, thereby ensuring dignity to this community.

delivery of donations and guidance on the above diseases on a Saturday morning. We believe we have successfully intervened in the population both assisting in the reconstruction of their homes, as with health education, basic principle in public health. The population proved to be interested in the information provided, as a lot of doubts and uncertainties in relation to such diseases, especially Zika, a disease that recently arrived in Brazil and appears to be responsible for an alarming increase in the incidence of microcephaly in newborns of pregnant women infected by Zika virus during pregnancy. The campaign included the majority interest of scholars of the early periods of the medical school, which has little experience in direct contact with the population and promoting health. Thus, this oppor tunity was rewarding and enriching, demonstrating to themselves their skills in dealing with the community and turn their academic knowledge into accessible guidelines. At the end of the campaign the students showed sensitized and motivated to participate in new campaigns throughout his medical training. References: Chaves, M. R. D. O., Bernardo, C. D., Filho, J. F. D., & Passos, X. S. (n.d.). Dengue , Chikungunya e Zika : a nova realidade brasileira Dengue , Chikungunya and Zika : new brazilian Febre de chikungunya: manejo clínico / Ministério da Saúde, Secretaria de Vigilância em Saúde, Secretaria de Atenção Básica. – Brasília: Ministério da Saúde, 2015. Dengue: aspectos epidemiológicos, diagnóstico e tratamento / Ministério da Saúde, Fundação Nacional de Saúde. – Brasília: Fundação Nacional de Saúde, 2002.

The main objective was to collect material goods that help to replace what had been lost to the floods, including furniture, personal use items, books, school supplies, food and toys. Also, inform and educate the community about contagious infectious disease transmitted by the mosquito Aedes aegypti, dengue, chikungunya and zika, which has a high incidence in the city's population and worrying mortality rates. 49

America's Llamas in Malta Pamela Delgado Barroso, Victor Leal Garcia IFMSA-México and IFMSA-Brazil In March 2016 America’s llamas had the opportunity to join in one of the most important IFMSA events, the General Assembly, which took place in the beautiful city of Luqa, Malta. Going to an international assembly is the perfect place for learning from different kinds of thinking and know the world that surrounds us, Is to get out of our comfort zone and go out to share and learn from others. It reminds you of what you got into IFMSA at first, the honor to work with all the people who feels the same way as we do, the people who wants the Earth to be a better place, where you can see that you are having the opportunity to make a valuable contribution to IFMSA and above all, to the world. The Theme Event was sustainable development goals. In recent years, IFMSA was involved in the process, and has allowed its members to gain insight into how the world could be, if formed by common and ethical goals. It is important to learn from the strengths and weaknesses of the Millennium Development Goals and the way in which they were implemented to improve the health outcomes of populations worldwide, which the march meeting achieved well. How can SCORPions contribute to this process? The SCORP regional session gave us the answer: be a leader, "make a SCORPion leader out of you". Not only we had the chance to talk in the SCORP sessions about many things, since learning the basic human rights, to gender´s equity, ethics in medical decision, children and women´s rights, and how all this things are taken along the different countries and cultures but also we could develop at the americas scorp session the soft-skills and hard-skills training relevant to Human Rights and Peace, not only touching on leadership skills but also discussing engagement of participants within our NMOs, problem-solving and motivation. It was great! We 50

learned that even though we can sometimes differ in opinion, at the end we all have the same goal, let's work together towards the crating of a better world!

Read with me Ricardo Clairefont dias Regis, Sergio Ferreira Santos da Cruz IFMSA-Brazil

The International Literacy Day is celebrated on September 8 and its main goal is to promote literacy in all the world. Literacy is the process of learning how to read and write, one of the responsible elements for the development of a country. In Brazil, reading is a powerful source for knowledge. However, in our country, many people are illiterate, and that is a horrible mark for all brazilians. In order to change that fact, The Standing committee on human rights and Peace (SCORP) realized a campaign called ``Read with me``. Before the campaign, the students received about 200 donations of books and comic books to give to children. They worked also to learn some dynamic activities to do with them, with the intuit of do a delightful visit, not boring. On 29 September 2015, students went in a public school in BelĂŠm, capital of the state of ParĂĄ, giving some advices to children about the importance of reading and the multiple benefits of this in their lifes. During the event, the students did the dynamic activities, stimulating the verbal and non verbal communication. There, the students did dynamic readings, where they read stories and children were encouraged to portray the scene of the narrative through the creation of a mural with the familiar characters. It was later made the famous "soletrando", which is an activity that the students say a word and children need to spell. At the final, the participants staged a story and at the end the children were asked about the moral of the tale. After the end of the activities, all were awarded with books. The children look like really happy with all the books that they have receive and new ideas about the importance of reading. At the end, the rest of books 51

and comic books were donated to the school library, for further use by the kids. In the end, the campaign was tremendous success. The campaign met the expected expectations, with a big acceptance of activities for the children and their active participation showing interest in reading and related activities. More than that, the children understood that the reading have a great importance in their lives now and will always have, whether in personal life, where they can update on what happens in the world with journal, for example, or professional life where reading help in his formation and in their professional growing.

Health Equity: a IFMSA Brazil’s Exchange Experience in Amazon Daniela Esteves Temporim, Marcello José Ferreira Silva IFMSA-Brazil

In 1988 was promulgated the National Constitution which established health as a citizen’s right and State devoir. This legal commitment thrived with the creation of the Public healthcare system as it is todaythe “S.U.S.”-, structured by Universality, Equity and Integrality as principles, therefore, aiming to grant massive population access to services and assets that should guarantee health in a whole and equitable way. However, concretion of the three virtues that substructure the SUS has proven itself at least challenging when taking into consideration State’s broad territorial dimensions and vast natural scenarios. How to, thereby, enable SUS extension covering to Ribeirinho –riverside- families and to those who reside isolated by hundreds of kilometers from the closest family healthcare unit (E.S.F.) or city center? Intending to better know the reality of the riverside inhabitants, IFMSA Brazil, through its NMO national Exchange programme, provided students the opportunity to take part in a Primary Healthcare Unit in a Ribeirinho community, responsible for 1300 families, in the sweeping Ponta de Pedras’ county, situated in Marajo’s archipelago- belonging to Pará’s province.

cause for the most common diseases found in their scope. Recurrent amongst these women, bacterial vaginal discharge is consensually- for local health workersresult of the habit of wearing wet clothes for hours, whilst children are frequently bothered by parasitosis - Entamoeba histolytica, Giardia lamblia e Ascarides lumbricoides. Another fundamental concept when trying to understand the Ribeirinho’s picture is perceiving the ex treme impor tance of unusual means of transportation. Canoes and boats are mandatory when it comes to moving alongside the streams from their houses to the healthcare unit, school, market, church, neighbors, city center, other cities, and are, hence, essential for their living. Confronted with watercourse logistics and the economic condition one should rapidly notice the impairment of Universality for the population there living. The gas/oil price comes into account as a major factor for these low income families which need to confront the long distance between their houses and the basic healthcare unit. The Family iterant basically faces the waiting strategy with either recovery of the ill, spread of the disease to other members or until aggravation of the condition –betaking the river only in the last two outcomes- all justified for gas saving.

According to researchers, the Ribeirinhos contribute demographically to Pará’s province with an amount of Comprehend public health as a fundamental human 40 thousand families- spread kilometers throughout right is to prosper in the concepts of health in its rivers, igarapés- living, therefore, riverside, adjacent to integral form, building up the human being in streams and in thickets. Lacking company/piped consonance with his peculiar way of life. For this water, there is disseminated fluvial dependency for reason, the experience with the ribeirinho simple daily activities such as cooking, taking community corroborates with the active quest showers, dish and clothes washing. The intimate commitment for the medical formation in agreement relationship of this population with the water 52 with the different peoples necessities. presents itself as an important direct and indirect

Free Hugs David Costa de Almeida, Débora Freire Coutinho, Hélvia Bertoldo de Oliveira IFMSA-Brazil

The “Free Hugs” is a widespread worldwide campaign, usually held in public places and consists to give hugs to unknown people. The hug beyond a demonstration of affection that contributes to good social and mental well being, also has an impact on the physiology of our body to trigger the release of oxytocin and endorphins. These substances are responsible for the organic component of the sense of well being, allowing maintenance people's quality of life. In the short term, the embrace decreases heart rate, blood pressure and decreases the level of stress, in addition to being a potentializer social interaction and empathy that can exist even among strangers. Based on WHO definition that health of an individual should also contemplate the state of emotional well-being, the Free Hugs is an action that allows the promotion of health. According to Kathleen Keating et al the hug therapy can become healthier who is already healthy, happier who is already happy and make the safest person among us feel even safer. The hug can change someone's day and build new perspectives in the deconstruction of suffering. The campaign promoted by the IFMSA Brazil Local Committee in the State University of Southwest Bahia aimed to provide the candidates of a college entrance examination a moment of joy, warmth and relaxation before the examination of this institution; promote and practice the humanization of future health professionals; provide the medical student training, approach to the population for health promotion purposes; disseminate human rights and peace. Previous training of campaigners has been made

about the importance of embracing in the physical, psychological and social well being and a dynamic activity of the types of hugs was performed. Moreover, it was also discussed human rights and peace. We conducted the campaign in Vitoria da Conquista city, lasting 4 hours on arrival and departure of the candidates from one of the test sites. The eighteen participants, including students of medicine and psychology addressed the people armed with funny posters to facilitate the approach. Thus, the hugs were given if the person allowed. We managed to cover 200 people accounted for an embrace of average per participant. We covered several socioeconomic types of people with a predominance of young people and adults. The campaign brought some tranquility in this unique moment in the professional future of the candidates. People who received this symbolic gesture of communion surprised us with various reactions such as laughter and tears of emotion. The vast majority of people proved receptive to the action being performed and many felt more confident and thanked the initiative demonstrating the sincere and cheerful human contact can provide brilliant psychological effects. Participants' expectations were exceeded. Committee members were quite satisfied with the results achieved in the campaign. And the goals were achieved with praise. References: 1-THERAPY HUG. Publisher: Thought, 1995. KEATING, KATHLEEN 2-The illustraded Guide to Free Hugs / Juan Mann in http:// manuelfritsch.de/files/The-Illustrated-Guide-to-Free-Hugs.pdf 3-The concept of Health / Marco Segre and Flavio Carvalho Ferraz (Rev. Public Health, 31 (5): 538-42.1997) 53 4-http://www.abracosgratis.blog.br/informacoes/

SCOME STANDING COMMITTEE ON MEDICAL EDUCATION

SCOME Regional assistant message

Lucas Rodrigues SCOME RA

Beloved SCOMEdians from the Americas Region, As you all know, SCOME works with many different areas, such as advocacy initiatives, activities and, of course, collaboration among NMOs. Every single day we have more people concerned about the future of medical education. We have SCOMEdians discussing curriculum changes, accreditation, working along with exchange officers to improve the recognition of exchanges in their universities. When we talk about activities in Medical Education, there are countless options of what we can do to improve the quality of our graduation. During this year, NMOs created new activities, continued older projects, engaged with the programs, and started developing a regional image for SCOME in the Americas. The regional collaboration is also incredible here in our region. We are having more NOMEs and LOMEs sharing ideas with other NMOs, we have NMOs that are starting SCOME right now and are getting help from experienced NMOs, and there are also the ones that are contacting the regional team and their peers in medical education more in order to improve the quality of our work all over the region. We have been learning so much and the following articles are just a small example of some things our region is doing in order to improve medical education. SCOME has been growing up at an unbelievable pace. All of that is due to the amazing work you all have been developing at a local/national/regional level. Is there a long way for us to go? Of course! However, what we have already done shows that we can follow this path. We can do it! Letâ&#x20AC;&#x2122;s show the world the power that comes from the Llamas! Lucas Rodrigues de Souza SCOME RA for the Americas

A big family called SCOME Pablo Estrella Porter  AEMPPI  Universidad San Francisco de Quito

Working in Medical Education is a key element for developing a new generation of global doctors. And that is what we have been working in with SCOME in the Americas and in my country, Ecuador. Medical students from all over the country, have worked together to make SCOME one of the most active committees, with more than 120 local and national activities per year.

We want to become a united region that creates globalized students who love what they do. This is an open call for every medical student in the Americas and in the world, to join the IFMSA family and become a SCOMEdian.

Our work in the committee has created projects, campaigns, activities, symposia and much more, in order to improve medical student’s skills and complement the education received in classrooms. Now, in Ecuador, we have many medical students working, side by side with the LOMEs and the NOME, for achieving bigger goals and projects that are more ambitious. We have been working to facilitate several tools and skills for advocacy and student representation. In that way, we want medical students to get involved actively in the decision making process of their own medical education. It is a hard and long process that will be enhanced through time, but has already started. In the Americas, SCOME is like a big family. We all work in different ways, with different tools, but with one same objective in mind. We want to be the positive change in our medical system worldwide. For that reason, we have developed a familiar work environment, where we share our ideas, experiences, successes and failures.

A training manual on climate and health: a new medical education tool in IFMSA Claudel P-Desrosiers IFMSA-Quebec

IFMSA has been for many years now a champion in finding innovative ways to teach and train medical students on global health issues that werenâ&#x20AC;&#x2122;t properly covered in the standard university curriculum. The standing committee on medical education of the Federation has tailored its approach to evaluate and assess the educational needs of students, allowing members around the world to improve their medical learning experience. Through non formal education, the Federation has played a key role in opening the eyes of future health professionals about topics such as public health, human rights and peace and sexual and reproductive health. In the past few months, a group of motivated students from around the world have come together to create a brand new training tool: a training manual on climate and health, developed i n c o l l a b o r a t i o n w i t h t h e Wo r l d H e a l t h Organization. Innovative in itself, the manual provides training and education opportunities for students on the health consequences of climate change, the co-benefits of mitigation, and the role of health sector in adaptation and mitigation efforts. It discusses climate change with a unique perspective on the health implications, impacts and opportunities; and showcases good practices and policies that protect and promote our health. Moreover, and most importantly, it provides resources to create, organize and lead activities in communities around the world through non formal education. A whole chapter of the manual focuses on capacity building, an approach to development that focuses on enhancing peopleâ&#x20AC;&#x2122;s abilities for them to achieve their goals and objectives, something SCOMEdians are very familiar with. 57 Through capacity building, we can strengthen the

skills, competencies and abilities of people and communities so they can overcome the various challenges they face. This section was added so that readers can get concrete tips on how to implement the things they have learned in the previous pages, and on how to share their knowledge with their peers. Workshops and campaign management are key to our actions, especially in IFMSA. As such, this new manual answers the need to crystallize the work and expertise of IFMSA in one specific field, and to ensure that the knowledge acquired by the institution is passed from one generation of leaders to another, especially in terms of capacity building, peer-education methods and organization methodologies. It is our hope that more of those initiatives will be seen in IFMSA, once more to impact in a sustainable way transnational generations of young people. Claudel P-Desrosiers IFMSA-QuĂŠbec Global Health Officer Lead author of the IFMSA Training Manual on Climate and Health

This year APEMH and SCOME is coming up with new projects Mayder Vilca Salasâ&#x20AC;¨ APEMH

Every year in October we meet with local representatives in a pleasant national meeting in which we discuss problems and seek solutions for them. Also, we devise new projects and in this article I want to share with you the new projects, that will come in our standing committee this year.

Many countries in the Americas have more than one language and in our country there are actually more than 3.36 million Peruvians that speak Quechua and we, as physicians and future health professionals, have a duty to learn to manage this language orally and in writing to provide better service and empathize with our patients. In order to do that, we developed the "Contribution in your regional language" project that will allow us to get closer to patients who speak Quechua through workshops where dialogues with frequently asked questions will be developed in Quechua and will occur in hospitals and health facilities.

Based on the needs of each local committee, we wanted to start with workshops on how to improve studying systems in our universities, to create ideas, solutions and share them nationally. Based on this, I know that we can create more projects. Sharing skills of our members locally and sharing knowledge about diseases in a country as diverse as ours led us to develop the "Interview with Doyens", a project that will allow medical students to develop communication skills by interviewing specialists in their cities and getting in contact with relevant diseases in their region. Then, videos will be made and shared nationally. Through this, we can contrast the differences and similarities of diseases, but also know new health entities that are not presented in our cities.

When we want to study issues, diseases and syndromes that have universal characteristics that guide us to identifying them, we make small concepts to remember them better so we developed the "MED SHOTS" project that will help us improve our system of study through discussion between students to define the main features of a given subject, which will be shared among all local committees.

Rare Disease Day

Roxana Galván Suárez; Aarón Israel Mancera Torres; Claudia Ivett García Padilla - IFMSA-Mexico In the past XXVI National Assembly of FIAEMMEX A.C. (International Federation of Medical Students Association, Civil Association) held in Mexico City from January 29th to February 1st in this year, through different sessions SCOME had the opportunity to make known to the local officers the importance of commemorating the day February 29th corresponding to "Rare Disease day" so we had a presentation by the GIST Foundation (Gastrointestinal Stromal Tumor) in which, incidence statistics, diagnosis, symptoms and treatment of GIST were shown; All of this was in ordered to inform Local Officers on Medical Education (LOMEs) about the situation nowadays about GIST and besides all diseases that are considered rare because of their low incidence and that therefore this is reflected in science as abandoned and orphan diseases having little research aimed at treatments in search of the cure of these. Following this, the National SCOME Team made the invitation to LOMEs that through their activities on Rare Disease Day, could impact students from their universities and at the same time more students will be aware of the existence of these diseases. A m o n g t h e a c t i v i t i e s c a r r i e d o u t we re : Presentations of different rare diseases, Williams Syndrome, Lysosomal Disease, How to suspect the diagnosis of these diseases as future first contact doctors, different informative boards and include currently by the committee CEREMUG of Leon, G u a n a j u ato, i s h o l d i n g a n I nte r n at i o n a l Competition of Scientific Informative Posters that aims to encourage research and raise awareness in students to improve diagnosis of rare diseases. The contest collected 60 participants currently in two 59 modes, online and presential and acting as jury

three expert doctors on the subject and the Mexican Organization of Rare Diseases (OMER).

Pharmacology Symposium: An initiative of IFMSA-Brazil CESUPA Local Committee

Victor Leal Garcia, Isabelle Pinheiro Amaro, Nicole Maués Flexa de Oliveira, Marina Geórgia Cruz Keuffer - IFMSA-Brazil

Pharmacology is the science concerned with the uses, effects and modes of action of drugs. It studies how different chemicals affect our systems. This subject is essential to health area professionals. Nevertheless, it is not well covered enough during the medical education, mainly in courses that use active methodology of PBL (Problem Based Le a r n i n g ) , l e a v i n g s o m e a p p r e n t i c e s h i p shortcomings.

We believe the goal was reached. We used an excellent approach about the subject. It was noticed that the Pharmacology Symposium attracted much attention – with the outstanding audience of approximately 150 medical students and the interests of medical students exceeding expectations. It was possible to solve many doubts, clarifying the following themes: Basic Pharmacology and drugs used in Sistema Único de Saúde (SUS) – Brazilian Public Health System – as a n t i - i n fl a m m a t o r y , a n t i - d i a b e t o g e n i c , antihypertensives, antibiotics and antiparasitic. It was focused in the importance of associating this knowledge with the clinical and socioeconomic reality of the patients. In this way, it is possible to conclude how essential it is to apply a teaching method with specific classes about Pharmacology in undergraduate courses. We encourage every Scomedian at our region to step up and work towards a better education for all our peers at the Americas Region.

As more medicines become available, pharmacology has become more important in determining the potential interactions caused by patients taking multiple prescribed, over-thecounter and homeopathic medications. Whether these chemical agents are natural or synthetic, they can have physiological and behavioral effects on those that take them.(1)

In medical school, the academics must receive knowledge of drugs pharmacodynamics and pharmacokinetics since the beginning of the course. However, many times this subject is just taught in advanced semesters. How could we tackle this issue? In IFMSA we learn and are encouraged to work with non-formal education alternatives in other to improve our own curriculum.

References: (1) http://www.living-arts-college.edu/medical/ (2)http://www.yeu-international.org/en/non-formal-education

The Pharmacology Symposium organized by IFMSA Brazil’s Local Committee CESUPA, intended to complement the education offered by University Center of Pará (Centro Universitário do Estado do Pará) and other institutions at the brazilian city of Belém, Pará. Our goal was to amplify the medical students vision about pharmacology associated with clinical and therapeutics knowledge.

Thanatology for medical students learning how to deliver bad news

Victoria Caroline Pagelkopf, Mariana Reis Nogueira, Marcos Henrique Fogale Piccoli, Thais Nigro Andreguetto - IFMSA-Brazil

Introduction: Bad news is part of the medical routine, however, its impact on the physician and patient is overlooked. The Hedonist Western Culture that tries to dissemble death, so the subject of death and the dying process is avoided. As a result, the ability to deliver bad news isn’t stimulated properly, which directly influences in many medical students badly prepared for delivering bad news and to face death. Objectives: the “Workshop of Bad News” was organized by the local committee FAMERP of IFMSA Brazil to awake empathy on medical students to deal with death. This subject is recurrent in medical prac tice and we aimed to promote the understanding of psychiatric and psychological mechanisms of communicating bad news and also promote the sensitizing of students on patient contact. Our final goal was to decrease patient, and even student, trauma, by stimulate better physician-patient contact. Methodology: 63 medical students attended a lecture that addressed palliative care and a mental view on patient and student facing death. The lecture was given by FAMERP teachers specially trained and with extensive experience in the subject. After being briefed on reporting bad prognosis techniques, the students, in small groups, attended in a workshop practice with hypothetical situations with actors, who were volunteers from a theatre company of the city of São José do Rio Preto, where FAMERP takes place. The students were trained in the ability of delivering bad news, empathy, communication, dealing with suffering and death. After the training, there was a student " feedback" on the performance, when the students themselves used 61 the knowledge gained in the lecture to help the

the colleagues and correct some mistakes that may occur and went unnoticed. Conclusion and Results: The practice was successful, and the students understood the importance of clear communication. Also, they were sensitized on death subject, dealing with it more naturally, focusing on empathy to the suffering of the patient with new learned techniques to comfort and avoid traumas. Therefore, we realized that even though the mental support isn’t always emphasized by medical graduation, it’s essential to enable physicians to handle and transmit information more effectively. So, the Workshop of Bad News fulfilled its role by training students to announce bad news protecting the patients and their own mental health.

Medical Residencies â&#x20AC;&#x201C; An approximation of experiences Daiene Tomie, Gabriela Olivieri Caramano, Ingrid Ganga Buzoli, Ligia de Carvalho, Victor de Oliveira Liberale IFMSA-Brazil

Introduction: The knowledge concerning medical residencies is limited to medical students, since most of them don't know how their career will look like in the future. Furthermore, there is a lack of communication between the residents and the recently graduated students in order that knowledge, difficulties, struggles and feelings are not shared. If it happened, it would help the view of a future reality and the planning of it. The need to make this reality closer to the students motivated us to make such an event to solve this problem. Goals: We know that there are some pre-concepts concerning each medical career. Therefore, The First Symposium of Medical Residencies came with the goal of bringing down these mistaken concepts, presenting recognized professionals who will bring forth information about some medical areas. For a student, as the medical course ends, doubts concerning the career that will follow come up. For some, this time represents a vocational dream coming true, while for others, it is time to judge the paths that were once wanted. It is a time of thinking, questioning and knowing yourself. Our goal is to ease this hard, struggling moment by providing professional information from various medical areas in order to clarify more about each residency. In addition, we want to motivate the freshmen to go after new information concerning the medical areas helping them to sympathize with one or many of those. Methodology: We chose professionals with rĂŠsumĂŠs that would interest the students so that in two days the symposium should cover residency legislations, residency application tests, the competition faced on these tests, current working market status, working areas, sub residencies, work 62 intensity, how long each residency course takes,

places of reference and the life during the course itself. We also invited the director of Residency Comission to present a more theoretical overview on the theme. Results: it was a deep learning experience not only to the sudents but also to the speakers, we were able to establish a connection between all these people involved so that the professionals and the students could sympathize with each other and share their doubts, hopes and aspirations. Discussion: The medical residency in Brazil was established by Decree number 80.281 on September 5th 1977 and was entitled as a post-graduation course, as if it was a specialization course. Although, not all medical students know such paths to post graduate courses to become specialists in a certain area, this knowledge is acquired as the six years of medical school go by, even then, some seniors don't have all the required information. One should think in various ways on how to supply the lack of certain information, likewise the symposium does, making sure the students don't have any more doubt and presenting the reality.

MEDICAL EDUCATION, more than just a classroom Ximena Alexandra Núñez Mejía  AEMPPI Universidad Internacional del Ecuador.

Medical Education has taught me to be the change I want to see in the world.

more similar to you than you may think, and that is what makes me happy, because it means we are not alone, and there´s a lot of people like you, who want to make a better world, by giving students the best medical education, in order to acquire a world with excellent healthcare.

After 3 years being part of something as big as IFMSA, I have learnt that becoming a good doctor is more than just going to classes at med school every day an getting a piece of paper as a tittle. You need to improve your skills, you need to understand health systems over the world and specially you need to be an integral doctor, capable of doing everything.

If I could go back in time and do things over again, I would choose SCOME one more time because I love to be part of a perfect place full of kind and perseverant people Who showed me that I can change things, as a student and with only 21 years I have a voice and the chance to say "let's do this to have better education" "let's do that to be the ideal doctor one day". That privilege it's only possible thanks to my OL, my NMO, SCOME and IFMSA.

But how can you become that superhero doctor you wanted to be since you were a little kid if you don’t have the means to do it in your University; SCOME can give you the answer, all you need to do is getting involved with this interesting committee.

Finally all I can say is do it, don't be afraid, involve with your future, take it with your hands and change everything you can to become the DOCTOR YOU ALWAYS DREAMT ABOUT.

Something I learnt by working with my NMO is that making changes is not easy, but is not impossible. The key to success while trying is making baby steps and may be going slow, one day at the time, but getting to the place you want to be. First you can make new projects or activities based on your faculty needs, in some cases you might have to do it more than one time in order to achieve the expected quality. Once you are 100% sure you did a great job you can present your ideas and results to your Dean, or may be your teachers first, so they know what you are up to and what you expect from what you are doing because at some point they can help you in more than one way with your final goals. Eventually you could change those things some people around you thought were impossible to improve in your faculty only by making the effort to believe it was possible and taking part in a place where every person you meet and work with is

Humanized Deliver y : The training of academics and the empowerment of patients

Karoliny Cecília de Oliveira, Vynicius Staut de Souza, Larisse de Oliveira Velozo - IFMSA-Brazil It is known that the humanization of assistance to the child's birth, is not, yet, a common practice in medicine and Brazilian hospitals. It’s evidenced by World Health Organization (WHO), that shows an index higher than 53% of cesarean deliveries, which puts the country as a world leader in this procedure. Disinformation and the consequent fear and convenience sometimes lead pregnant women, and even doctors, to opt for surgery unnecessarily. In order to add new perspectives to health students and inform mothers and families of the city of Porto Velho on the subject, it was conducted by members of IFMSA Brazil - Local Committee FSL a CineMed Project, in partnership with teachers from São Lucas College, and the Regional Council of Medicine of Rondônia. The screening of the documentar y " The Renaissance Childbirth" suggested new questions extending the concept to Humanized Birth. In the discussion of the speakers and guests, including physicians, nurses and doulas, the ideal cesarean rate, established by the international medical community, should be between 10% and 15%. It was also exposed the increasing number of these indices throughout the world in both developed and developing countr ies. That wor r ies, increasingly, government officials and professionals about the potential negative consequences on maternal and child health. It was a remarkable assimilation of knowledge and opinions for all 120 people present. It was an empowerment on the exercise of the medical role in the choice of the patient, especially with regard to medical students. It was found that, beyond an aggravating public 64 health, high rates of unnecessary cesarean-sections

are also a cultural issue. For decades, in Brazil, a tendency to deliveries of accomplishments of this kind is noticeable. Factors such as cost, poor doctor-patient relationship and prejudice are prevalent to an inappropriate choice of an obstetric method. It also infers that the centralized procedure only on the physician without the par ticipation of a multidisciplinary team, which is still common in the country, tends to aggravate these conditions. Wrongly , for many Brazilians , natural childbirth is synonymous with suffering, since alternative methods that can ease the process are often not used as the vertical position of women and the administration of ocitocina. It is undeniable that cesarean sections, when carried out for medical reasons, can dramatically reduce mortality and maternal and newborns morbidity, as well as offering more convenience and speed to the process. However, given the risk that any surgical procedure, it is unjustifiable the practice in the absence of such statements. The immediate and long-term risks to women and baby's health or to future pregnancies are far superior than the benefits of surgery. Therefore, it is necessary to demythologizing the subject, primarily in medical schools and in the doctor-patient relationship, encouraging future professionals to practice their occupation in a holistic manner, and guarantee the right of women's autonomy over their body. References: 1.

2. 3.

TEIXEIRA, Kátia de Cássia. BASTOS, Raquel. Humanization of birth . Paper presented at the IX National Congress of Education and III South Brazilian Meeting of Psychology - PUCPR , 2009 . WHO statement on rates of Cesareans, 2015. Available in http://apps.who.int/ iris/bitstream/10665/161442/3/WHO_RHR_15.02_por.pdf DINIZ, Carmen Simone Grilo. Humanization of childbirth care in Brazil : the numerous meanings of a movement. Ciênc. Public health, Rio de Janeiro. Available in < http://www.scielo.br/scielo.php?script=sci_arttext&pid=S141381232005000300019 >.

SCOME in IFMSA-El Salvador

Laura Victoria Cienfuegos Alfaroโ จ IFMSA-El Salvador Universidad Autรณnoma de Santa Ana

SCOME in IFMSA El Salvador was founded on 2001 and since then, has been growing up every year! Currently, we have 3 local committees that are working with medical education for our NMO. Our main focus in the medical education of our students. In order to do so, we develop trainings about vital signs, introduction to the medical career, hand washing, electrocardiography, radiology, first aid and also how to read laboratory tests, for example. We believe those topics are important because they use non formal education and create opportunities for the medical students to know more doctors and other health professionals. This year we are just beginning and, still, there are many ideas and activities that have been made. Here are 2 of our first projects. We always try to have a doctor with us to have the best trainings and resources for always learning more. The first activity that was done this year involved working with the new medical students, with the project Introduction In My First Year, by ASEMEDU ( Asociaciรณn de estudiantes de medicina de UNASA) emphasizing the importance of our profession in the society, the new environment they are discovering, materials and books they can use, and some tips from veterans on how they could study subjects considered more difficult. Another project was Vital Signs , by ASESMED (Asociaciรณn de estudiantes de medicina de Universidad Evangelica de El Salvador) where students had a training about taking vital signs, something basic but crutial that every doctor must know how to do. 65

Just as we have said, this is just the beginning of this year. There are still many other ideas, such as working with other NMOs and Standing Committees, creating new projects that could have a national and international impact and develop ways of making SCOME more attractive to our medical students, so they will keep working for it and continue using non formal education as a tool of improving medical education in El Salvador.

The experience of the contact with children and adults with autistic spectrum disorder Thays Brunelli Pugliesi Beatriz Daudt de Paiva  IFMSA-Brazil

The term “autism” was first introduced in the psychiatric field in 1906. Nowadays, the Autism Spectrum Disorder is a part of an extensive group of conditions called Global Developmental Disorders. Autistic Spectrum Disorder (ASD) includes Autism; Asperger Syndrom, and Global Developmental Disorders Without specification. The ASD has a variety of clinical scenarios and many symptoms and signs may or may not be present, but the isolation and the conduct disorders are always there. The symptoms begin in early life, and the three main characteristics are: language disorders; social interaction disorders; and behavior repertoire disorders. The estimated prevalence is 1 in 88 children, confirming that autism is one of the most common disorders there are. The etiology is complex and its pathological mechanism has been studied. Aware of the importance of early diagnosis, members of IFMSA Brazil – Local Committee PUCSP, along with the Academic League on Medical Genetics and Sorocaba's Autistics' Friends Association (AMAS) proposed the development of a project in which the objective was to provide contact with individuals with ASD, within the limitations imposed by the syndrome, so that students can have the possibility of a real encounter with these disorders and raise awareness about the individual problems of each patient, not only within medical training, but also in human development.

the lesson, it was discussed the probable causes of ASD, its signs and symptoms, its comorbidities and non-pharmacological treatment and pharmacological treatment of comorbidities (depression, aggressiveness, sexual stimulation). In the second and last phase, the students could visit the infrastructure and meet the patients who attend to AMAS, always respecting the limitations and knowing the history of each one of them. They could talk to the employees and families and doing so, they could get a closer view in their day-to-day lives. At the end, the students seemed surprised and pleased with the activity because they came into direct contact with the autism and demystified the disease, establishing new and different ways to contact them. It was a good time to answer questions about the disease, overturn myths and stigmas and know the everyday difficulties that people with ASD, their families and their caregivers face. In addition, they discussed among them the importance of next intervention - this time with the parents. The project collaborated with the academic training of students and, it is hoped, they will be able to recognize and diagnose this disorder, so prevalent in our professional future. Still, recognizing how extensive multidisciplinary treatment of ASD is performed, the students may contribute to the quality of life of these patients and improve their humanity's relationship with medicine. References:

The project was divided into two phases. First, GADIA, A. C. et al. Autismo e doenças invasivas de desenvolvimento. Jornal de Pediatria, 80, S83-S94. 2004 there was a lecture with a genetic expert on the GUPTA, A. R.; STATE, M. W. Autismo: genética. Rev.Bras.Psiquiaria, São Paulo, v.28, definition, clinical profile, symptoms and supl.1, maio de 2006. treatments of genetic syndromes emphasizing MINISTÉRIO DA SAÚDE. Diretrizes de Atenção à Reabilitação da Pessoa com ASD. At the beginning of class, a video that told the 66 Transtorno do Espectro Autista (TEA), Brasília, 2013. REGO, S.W.S.E. Autismo: Fisiopatologia e biomarcadores. Maio 2012. 66 story of one of her patients was presented. During

Scomedian support: a tool for increasing the quality of activities Mário Fernando Dantas Irineu Vieira Lopes Neto IFMSA-Brazil

SCOMEdian support was created in 2015, at Universidade Federal do Pará (UFPA), a local committee from IFMSA Brazil.. The project aimed at increasing the quality of the students’ capacity building before they went to the develop their local committee activities on SCOME, SCORA, SCORP and SCOPH. From January to November - 2015, scomedian support has already discussed 20 different topics, such as Diabetes, Teenage Pregnancy, Autism, Down’s Syndrome and some other topics that became activities at UFPA local committee. Still on the first semester of 2015, others medical schools started the project too. By the end of the year, four new brazilian medical schools were participating of the project. One of them is Universidade Vila Velha (UVV), where the project discussed about Hug Therapy, Thyroid Diseases, Clown Therapy, Autism and Obesity. The methodology of the activity consists on the creation of a scientific literature reviews about the theme chosen for a Standing Committee campaign. After this, the organizers of the project facilitated Problem-Based Learing (PBL) sessions before the campaigns, so the participants had some time to read the literature review before the session. Each literature review took about 48 hours to be written, and had an average of 5 Local Officers on Medical Education dividing it in small topics and writing about it. After the review, the coordinators would format the text for the brazilian standards or Vancouver’s. The review is sent about 1 week prior to the PBL session and was shared by email and some printed copies. Enough time for students to read the texts, maximum of 15 pages and, if any questions, ask them for specialist teachers. 67

The adhesion of the campaigns’ participants to discussions met the expectations of the Scomedian support coordinators. Before long, the project began to be seen a necessity for the capacity building process before the campaigns and so it happened for all four medical schools participating in the project. Scomedian Support proved to be an effective capacity building tool not only for the participants of the campaigns, that had improved their theoretical knowledge about the campaigns’ subject, but also for LOMEs, that had the oportunity to improve their knowledge about database research and scientific writing.

SCORA STANDING COMMITTEE ON SEXUAL AND REPRODUCTIVE HELTH RIGHTS INCLUDING HIV/AIDS

SCORA Regional assistant message

Carlos Acosta SCORA RA

I am very glad to present you the ludacris, inspiring, and fighting reasons why we believe sustainable development has a key component called Sexual and Reproductive Health Rights (SRHR). I feel really happy of the fact that I’m not alone in this battle. I have an army full of SCORAngels that have my back and help me beat stigma and discrimination the best way we can. We have achieved incredible things! We’ve talked about maternal health and access to safe abortion, we’ve made incredible international campaigns, we did for the first time ever a SCORA Session on LGBTQ+ health in our regional meeting and many more achievements we must be proud of. Although these are reasons to celebrate… We have a long way to go Every day is a rEVOLution and so I’m taking advantage of this space to call all action for our movement, for our federation. Our current context in the IFMSA evidence the need of a little more SCORA power in order to make medical students notice the importance of defending women’s rights, diversity, and many more other vulnerable cores. It is a time to inspire people to see through medical books and through the concrete concepts we have of health and medical understanding. It is a time to inspire people to see through medical books and through the concrete concepts we have of health and medical understanding. The magic of noticing these aspects is that we discover each day new things that rationally don’t fit in the enclosed model that we’ve settled as evidence based medicine. What if I told you there are things that can’t be evidenced? That are not Meta analysed? That can change our way of thinking? These things are the ones we work with in SCORA. They are factors that we don’t understand but that exist because of inertia, because they change matter (in this case expressed through diseases). The thing many students don’t know is that we forget we are part of society. We are as well a juncture of these invisible factors that tend to lead us to make certain decisions our express ourselves in the same way. Having said this, we really have a hard time to stay humble and accept our internal determinations. Why the pep talk? Because there is always more than one scenario of gender based violence that I can recall from an NFDP party, because there is always gender inequality amongst delegations that attend GAs, because there are people living with HIV, from the LGBT community fearing to suffer discrimination if they disclose in the IFMSA. Change comes from the inside… If we don’t change ourselves, how can we promote change in others? Enjoy these amazing articles!!! Love you tons, Carlos

Breast Cancer: Let us take action! Christopher Murray, Angelica Baker JAMSA-Jamaica

A diagnosis of breast cancer is often directly linked to a woman’s family medical history, lifestyle choices, or her environment. She has no control over your family’s medical history, and only some aspects of her environment can be modified. Lifestyle choices like diet, weight, exercise, and smoking are hers to manage. Jamaican Medical Students Association’s Standing Committee on Public Health (JAMSASCOPH) organized and hosted a Breast Cancer Workshop for the members. The aim of the workshop was to spread awareness of breast cancer throughout the University of the West Indies (UWI) community starting with the future medical practitioners and to empower women and men with the knowledge necessary to protect themselves against the disease and to educate themselves and others. By informing our members, we took the first step in reaching out to many individuals and homes who we hope will get the message of taking action against breast cancer. Evidence based medicine has taken somewhat of an imperative role in the practice of medicine today and with that in mind, Christopher Murray, our Cancer Awareness Director, delved into his latest findings of breast cancer research. He shared with us that researchers from Harvard T. H. Chan School of Public Health found that a diet high in fiber while young may reduce breast cancer risk. They determined that women who ate lots of fruits and vegetables when young had a “significantly lower risk” resulting in a 12%-19% chance of developing breast cancer. He also discussed promising new drugs that have been shown to greatly increase the chances of complete tumor removal. Dr. Sheray Ward-Chin,Consultant Medical Oncologist, The University Hospital of the West Indies (UHWI) started with a discussion about the prevalence of 70

cancer and the importance of early detection. This is one of the major issues we face in our population as women tend to present very late, most times with advanced stages of cancers as a result of not having annual screening done in the form a mammogram. These are the areas we want to impact by encouraging persons to become health literate and to develop better health seeking behaviours. If persons know more about the disease, the risk factors, symptoms and signs as well as the possible outcomes, then they will be able to make educated decisions concerning their health. Dr. Ward-Chin stressed the importance of regular screening and dispelled the myth that breast cancer is only a woman’s disease. Yes! Men can develop breast cancer as well. Those who attended expressed that they left more informed, more empowered, and more aware and as public health ambassadors to share the information with the target groups who very well includes them as well. References: 1-Hook. D. Top 5 Cancers Affecting Women, Retrieved from http:// www.everydayhealth.com/womens-health/cancers-affectingwomen-today.aspx

HIV in Chile: How early are we preventing? Franco Paolo Bavestrello Retamales IFMSA-Chile

According to survey results last year, the numbers of young people with HIV screening have been a sharp increase. In Chile, during the period 199-2003, they were detected 168 cases, while in the period 2009-2013, 390 cases, considering an increase of 132% of cases. Apparently, and as prescribed by authorities, this increase in numbers could be due to an alleged increase in detections because of greater realization of HIV testing to young people. But despite this, a survey of teenagers showed the same alarming results in issues of sex education, being for example, a characteristic that only half of them declares to use condoms in their first sexual intercourse and 29.2% used it in his last relationship But on the other hand, some experts argue that inclusive, case detection Ought to increase, and therefore, urge public authorities to further promote prevention policies that encourage young people to the HIV test, and also that work hard in the area of sex education. Regarding the Sex education issue, the numbers of young people survey puts the national reality shows about deficiency that exists in the Chilean system of sex education policies. Some experts believe that this ought to be implemented early at school level, ideally from the stage of childhood. The current question is whether Chile has adequate sex education programs aimed at children and adolescents, and if any, what was the reason for the low effectiveness of these in reducing HIV figures at an early age. At first glance, it seems that although Chile has managed to reduce vertical HIV transmission and manage complications of this disease, the incidence71

has been increasing. The challenges, therefore, which are slated to pose for policies in public health must be be a marked increase in promoting the realization of the HIV test, a reinforcement on issues of sexual health, targeting mainly in young sectors, and ideally taking them its context in order to internalize best practices in HIV prevention in these, and finally, reduce as much as possible the existing social stigma in Chile to HIV patients (+), and in turn, to improve the reintegration of these social and workplace. References: 1-http://www.med.uchile.cl/2013/9012-seminario-sobre-elvihsida-abordo-los-avances-problemas-y-desafios-del-pais-frentea-la-enfermedad.html 2-http://www.fundacionsavia.cl/articulos/73/ 3-http://w w w.latercera.com/noticia/nacional/ 2015/10/680-652733-9-alza-de-74-en-casos-de-vihsida-enadolescentes-preocupa-a-autoridades.shtml 4-http://www.who.int/features/2013/adolescents-hiv/es/

Obstetric violence and humanized birth: reality of women in latin america Joritzel Quijano IFMSA-Panamá

It’s disguised by population ignorance, physician malpractices or even female hysteria getting through obstetric processes; it’s an under – reported, disdained and omitted issue. Violence against women constitutes a Sate problem, since it’s the most frequently transgression of the human rights, and it’s a public health problem which leads into high economic and social costs. Many people don’t realize that physical wounds are not the only ones to heal, that’s why it’s often hard to visualize the different ways of violating or attempting against women integrity. Obstetric violence: This term first appeared in Latin America during the 2000s. UNESCO defines it as “the violence by health professionals over women bodies and reproductive processes”. It’s expressed in a dehumanizing treatment, invasive practices, the abuse of medicalization of natural processes, coming to a loss of autonomy and the capacity to decide widely about their bodies and sexuality having a negative impact in women life’s quality. Obstetric violence occurs during pregnancy, childbirth and the post-partum period and it occurs both in public and private medical centers. During pregnancy, women require a dignifying health care to get through its course, but it’s often associated with suffering, humiliations, ill-health and even death. Many women who experience disrespect and abuse during childbirth are less likely to look for skilled health care in the future. Is not an urban legend, it’s a reality Human Rights Commission received 122 complaints 72 about obstetric violence. Due to these complaints,

Venezuela was the first country in the world in recognize and punish the obstetric violence. In Mexico, between 2009 and 2012 the National Human Rights Commission received 122 complaints about obstetric violence. Due to these complaints, the government has recently added “obstetric violence” to the “General Law of Women’s Right to a Life Free from Violence. In the Dominican Republic, teen women are targets of obstetric violence in health services. A study carried out in two maternity hospitals of the city of Santo Domingo indicates that 78% of adolescents surveyed (between 15 and 18 years) were subject of ironic and disqualifying comments. In Chile, around 250,000 women become mothers every year. It’s estimated that a 92% of those women suffered some kind of maltreatment by health providers. An interview realized to Violeta Osorio, founder of the OMS Observatory published that only 12% of childbirths require a surgical intervention, but in Argentina we find 40% of childbirth happening in that way, that is linked to the lack of guarantees of health rights. At least, 70% of women with children have been victims of this type of violence in this country. These are only some from the millions of cases of obstetric violence happening worldwide. The State is responsible for institutional violence when women are denied the access to health services, treated inhumanely and disrespected her autonomy; but the lack of information about this issue and the fear of talking from the victims complicates the prevention and eradication of this under-estimated and silent type of violence.

Gender equality as a core value for IFMSA Ignacia Alvarez IFMSA-Chile

Being a feminist was never a huge part of my life. Donâ&#x20AC;&#x2122;t get me wrong, being a feminist was so natural for me and all the aspects of my personal life that I never had the need to actively consider advocating for gender equity in my past. I could say I was privileged to live and develop myself in an environment where being a woman was never seen as an impediment for achieving success. Nevertheless, giving a deeper look into my society and female perception, I do acknowledge sexism was a part of my early years in the form of subtle sexist micro-aggressions and I recognize the damaged patterns that developed in my brain as a consequence of being raised in a sexist society, where gender roles are still relevant, and gender equality a distant dream to achieve. I did recently realize, that we, as youth, must be the leading drive of the change for our and future generations. The Chilean version of IMAGES (The International Men and Gender Equality Survey) revealed the reality of our latin american society; 70% of Chilean men declared that household activities and the daily care of children it's the exclusive role of women, one third of the male interviewed population declared being physically abusive with their female partners, and 10% of Chilean men justifies violence towards women (1). The provided data its deeply disconcerting, but in this very moment I realized that we can only change this perspective by providing youth and future g e n e r a t i o n s w i t h a s e c u re, g e n d e r e q u a l environment. We have a strong personal role in fighting for gender equality just by realizing the numerous sexist situations that we passively accept, and sadly sometimes replicate in our daily lives. 73

The IFMSA is not unconnected to this issues, and even though we provide extensive, productive and successful platforms for advocacy and capacity building in concepts of women's rights and health, we lack broad assessments of gender equality in our own organization. Women and men in IFMSA are easily the most capable and resourceful group of youth you will get to face in your lifetime. But just like me, some of us grew up in societies where gender equality it's extremely underdeveloped, and sometimes we let some discomforting situations just slip through the cracks. I decided to write this article as an invitation for the readers I might have to address this situation in your local, national, regional and international events and discussions. An invitation to take the lead in gender equality issues, to assess and recognize threats to this important, to raise your voice against situations others may unseen, and to implement innovative strategies in your NMOs that might serve as an example for larger efforts in our federation so we proudly claim in the future to be a gender equal organization. References: 1-Aguayo, F., Correa, P., Cristi, P. (2011) Encuesta IMAGES Chile Resultados de la Encuesta Internacional de Masculinidades y Equidad de GĂŠnero. Santiago: CulturaSalud/EME

Womenâ&#x20AC;&#x2122;s Health: Accomplishing Gender Equity Luiza Minussi, Maria Renata Mencacci Costa DENEM-Brazil During the 40s, a new conception of "being a woman" was brought to discussion by feminist thinkers such as Joan Scott and Simone de Beauvoir. This deeper conception of gender definition detaches the biological part (male and female) of the social constructions featuring a man and a woman. We start from the principle that a woman is a woman not only because of its genotype or because of phenotype; it is rather a complex interaction between biological, cultural factors, attitudes, interpersonal relationships, religion, attributes and roles. With the formation and development of this concept, the feminist movement view to the organization of society begins to change and we can then the importance of specific social policies to the gender.

, for example, domestic and sexual violence. The following year, at the Cairo Conference (ICPD 1994), it was decided that all countries should commit to promote actions to guarantee sexual and reproductive rights of women. In this scenario, unsafe abortion was to blame for increasing mortality rates and maternal morbidity worldwide. Banned or poorly regulated abortion led women to commit abortions in a clandestine scenario, often putting their lives at risk due to poor conditions. Therefore, in 1995 in the Beijing Conference, there was recommendation to review legal penalties for those women that proceeded with having an abortion.

Neglecting the issue of abortion for a moment, even Considering the per formance of our social though this was an agenda topic relevant worldwide, environment in the woman's life and the concept of Brazil, in 2003 during its 12th National Conference on health, we can perceive during the 60s and 70s that Health begins to recommend the offer to the health of attention to their health was always directed their the woman should begin to consider the specific needs biological and reproductive functions. This of black women, lesbian, urban, rural, gender and reductionist view has created a system where there is indigenous professionals. Complementing the health a lack of a comprehensive approach to women's care of women, though still limited to their health. We see the need to look into the health reproductive rights, the conference said natural birth policies the concept of gender equity. It aims to should be stimulated with access to analgesia and that reduce unjust inequalities and have the ability to access to caesarean section, when necessary, be change. The intention is to reduce the inequality in guaranteed. All of this through the public health the access to health, to make specific public policies system (SUS), the program was called PNAISM created for each difference with specific preventive (National Plan for Integral Attention to Women's actions, seeking materials and medicines that meet Health). this differentiated part of the population. Causing women to have access to consistent services with Since all these advances in the development of the their real needs. concept of gender and its role in the social In the 90s, most of the discussions worldwide on determinants of health and disease for the women women's health where boosted by the WHO, being process, we can highlight some key issues in health the high point in 1993 at the International care this group: First, women must be met at all levels Conference on Human Rights, when the organisation of specificity, sheltered age and social environment declared as a violation of human rights any practice 74 (rural, urban, indigenous, prisoners, sex worker, hard to violating womenâ&#x20AC;&#x2122;s rights. In this concept, we include, reach areas). Second, the reduction of maternal

mortality should receive serious attention. Some social determinants affect this statistic such as rich woman, poor, black, and white, residing in rural or urban area. Third, differences in access to health and should be reduced, regardless of these factors, they should all get access to quality health services. Emphasizing that, in Brazil, the maternal mortality rate in black women is about 6 times higher than in white women. The decrease of these numbers involves providing access to prenatal care, ensure access to abortion in cases of unsafe pregnancy, childbirth care, puerperium, and risk pregnancies. Fourth, female specific illnesses should receive attention also specifies. The prevention and control and cancers such as the cervical and breast should be encouraged. Fifth, attention to women in menopause. We know it is a period of many bodily changes for women, so medical care in this period is important for it to maintain its quality of life. Sixth, the working woman assistance. Last but not least: assistance to victims of domestic or sexual violence should receive attention to their physical and mental health. Therefore, health policies related to women should be formulated, and renewed every time, according to the context of women's needs and the historical period in which they live. Social movements must go refining their claims so, help in the construction of attention to women's health and, more than that, in improving References: -Brasil. Ministério da Saúde, Secretaria de Gestão Estratégica e Participativa, Departamento de Apoio à Gestão Participativa e ao Controle Social. (2010a ). Saúde da mulher: um diálogo aberto e participativo. Brasília: Editora do Ministério da Saúde Recuperado em 04 de maio de 2011, de http:// portal.saude.gov.br/portal/arquivos/pdf/ saude_da_mulher_um_dialogo_aber to_part.pdf. -TAMANINI, Marlene. 0 processo saúde/doença das empregadas domesticas: gênero, trabalho e sofrimento. Revista de Ciências Humanas, Florianópolis, p. 49-69, jan. 2000. ISSN 2178-4582. Disponível em: <https://periodicos.ufsc.br/index.php/revistacfh/ article/view/25761/22560>. Acesso em: 31 mar. 2016. doi:http:// dx.doi.org/10.5007/25761. -Organizacion Mundial de la Salud. Estudio multipais de la OMS sobre salud de la mujer y violência domestica – Primeros resultados sobre prevalência, eventos relativos a la salud y respuestas de las mujeres a ditcha violencia. -Brasil. Ministério da Saúde, Secretaria de políticas para as mulheres (Outubro 2014). PNAISM, monitoramento e acompanhamento da política nacional de atenção integral à saúde da mulher e do plano nacional de políticas para as mulheres PNPM.

-Equity in law: a Brazilian health system’s principle? 1 Departamento de Saúde Coletiva, Faculdade de Medicina de Petrópolis e Curso de Nutrição da Faculdade Arthur Sá Earp Neto, rua Machado Fagundes 326, Cascatinha, 25716-000, Petrópolis, RJ. rabelais@zaz.com.br Cristina Maria Rabelais Duarte 1 AVILA, Rebeca Contrera; PORTES, Écio Antônio. A tríplice jornada de mulheres pobres na universidade pública: trabalho doméstico, trabalho remunerado e estudos. Rev. Estud. Fem., Florianópolis , v. 20, n. 3, p. 809-832, Dec. 2012 . Available from <http://www.scielo.br/scielo.php? script=sci_arttext&pid=S0104-026X2012000300011&lng=en& nrm=iso>. access on 31 Mar. 2016. http://dx.doi.org/ 10.1590/S0104-026X2012000300011. CYFER, Ingrid. Afinal, o que é uma mulher? Simone de Beauvoir e "a questão do sujeito" na teoria crítica feminista. Lua Nova, São Paulo , n. 94, p. 41-77, Apr. 2015 . Available from <http://www.scielo.br/scielo.php? script=sci_arttext&pid=S0102-64452015000100003&lng=en& nrm=iso>. access on 31 Mar. 2016. http://dx.doi.org/ 10.1590/0102-64452015009400003. COSTA, Ana Maria. Participação social na conquista das políticas de saúde para mulheres no Brasil. Ciênc. saúde coletiva, Rio de Janeiro , v. 14, n. 4, p. 1073-1083, Aug. 2009 . Av a i l a b l e f ro m < h t t p : / / w w w. s c i e l o. b r / s c i e l o. p h p ? script=sci_arttext&pid=S1413-81232009000400014&lng=en& nrm=iso>. access on 31 Mar. 2016. http://dx.doi.org/ 10.1590/S1413-81232009000400014.

The Vagina Monologues by Eve Ensler Angela Abouassi IFMSA-Grenada

The Vagina Monologues is put on across the world by V-day and 1 Billion Rising as the biggest mass action to end violence against women in human history. Vday is an activist movement worldwide that is used as a catalyst to promote anti-violence organizations1. Through various means, such as performances, fundraisers, campaigns, V-day works to educate and change social views and attitudes towards women. On the 15th anniversary of V-day, the activist movement launched its largest project to date called 1 Billion Rising1. 1 Billion Rising was launched on Valentine's Day 2012. The campaign began as a call to action based on the staggering statistic that 1 in 3 women on the planet will be beaten or raped during their lifetime. Given that there are over 7 billion people on the earth, this adds up to MORE THAN 1 BILLION WOMEN AND GIRLS. On 14 February 2013, people across the world came together to express their outrage, strike, dance, and RISE in defiance of the injustices women suffer, demanding an end to violence against women1.

know they are not alone. Thus to contribute to this powerful force, IFMSAGrenada put on a production of the Vagina Monologues in order to raise awareness around pressing issues surrounding the female experience. Through the performance we were able to raise nearly $2000 for Grenada Planned Parenthood Association, an organization devoted to the health of women, as well as speak out against violence against women. When women are given a voice and a platform amazing things can happen. What does it mean to be abused, what is the psychological impact of being raped, how does it feel to be told that you are inadequate or not enough or not perfect? These are all issues addressed by the Vagina Monologues. Although we like to believe that our world is progressing and that we are moving towards a world that is free of violence and injustice, unfortunately the data is staggering in terms of the inhumane treatment of women across the world.

Putting on a performance is just one of the many As empowering as these performances are, one of the ways to promote the message of both V-day and of 1 most essential things we can learn is just how Billion Rising. The goal of these performances is to staggeringly prevalent acts of violence against women bring to the forefront the topics our society tends to are. V-day, 1 billion rising, the Vagina Monologues all want to ignore. The Vagina Monologues is made up of just highlight the unacceptable truth that so many a series of diverse monologues, touching on topics women face violence in their lifetime. Why do women like love, sex, rape, pubic hair, menstruation, orgasms often stay with their abusers and why do many women and more. They are intended to draw attention to the suffer in silence? These questions are complex, they are female experience and are centered around the multifactorial and they will require a multidisciplinary recurring theme of the vagina. While many of the approach to achieve sustainable solutions. When we monologues are humorous, others are graphic and look at the rights of women in the work place and in painful to hear, they are intended to end the silence society and in terms of freedom in decision making for surrounding violence against women. We must first personal health and sexual health, the pieces of the and foremost prevent these horrid acts against staggeringly unacceptable problem start to come women and we must let the stories of victims be 76 together. The only way that we will begin to progress heard so that others who may be suffering in silence towards lasting change and an end to violence against

The Vagina Monologues can get the vital conversation started across the globe, to bring to light issues that are ignored that no longer can be. Womenâ&#x20AC;&#x2122;sâ&#x20AC;&#x2122; lives are on the line and there is absolutely no time to waste. We can bring about change with one performance at a time and seeing the policies and legislature that results because of bringing these issues to light. One billion women need to be saved from unjust abuse, we must start by letting the stories of these women be heard so that one day we never have to hear another victim of abuse talk about how they suffered in silence.

Breast and Prostate Cancer: A Warning Larisse de Oliveira Velozo, Karoliny Cecília de Oliveira Ribeiro, Vynicius Staut de Souza IFMSA-Brazil According to the Brazilian National Cancer Institute Jose de Alencar Gomes da Silva (INCA), breast cancer is the most common among women in the world and in Brazil, after Skin Cancer (Non-Melanoma), representing about 25% of new cases each year. It’s relatively rare before 35 years and over this age its incidence is growing steadily, especially after 50 years. There will be 57,960 estimated new cases in 2016. In Brazil, among men, prostate cancer is the second most common, after only non-melanoma skin cancer. In absolute terms, it is the sixth most common type in the world and the most prevalent in men, representing about 10% of all cancers. More than any other is considered a cancer of the elderly, because three-quarters of cases happens over 65 years. There will be 61,200 estimated new cases in 2016, according to data from INCA.

was conducted in which everyone performed a breast self-examination being observed by the students for help. With self-examination the woman knows in detail their breasts, which facilitates the perception of any changes to report to the doctor. When breast cancer is diagnosed early and treated properly, the prognosis is better. The cycle of lectures on women's and men's health was excellent, it integrated professions and emphasized the importance of the multidisciplinary team. The purpose of spreading knowledge has been completed and the students showed interest in the topics, asking a lot of questions to the speakers. The breast self-examination Workshop was of great learning, personal and didactic. We hope we taught the women to become aware of their bodies needs, to be always attentive to any signs or symptoms and to

Concerned about this scenario, students from IFMSA Brazil - local committee Faculdade São Lucas participated in the first Workshop of Multidisciplinary Health Care for Women and Men, with the objective to promote knowledge to students and professionals and inform the public. It happened during three days of November. On the first day (November 19th) the event was publicized. On the second (November 20th), lectures was done about prostate cancer and on the next morning, breast cancer lectures. In the afternoon our committee was responsible for a breast self-examination workshop. A Gynecologist and Obstetrician doctor previously trained the students some days earlier. The workshop's target audience were women, students of the institution and the community.

References: 1. Política nacional de atenção integral à saúde do homem: princípios e diretrizes / Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Ações Programáticas Estratégicas – Brasília: Ministério da Saúde, 2008. Disponível e m : < h t t p : / / b v s m s . s a u d e . g o v. b r / b v s / p u b l i c a c o e s / politica_nAcional_atencao_saude_homem.pdf> 2. Política nacional de atenção integral à saúde da mulher: princípios e diretrizes / Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Ações Programáticas Estratégicas – Brasília: Ministério da Saúde, 2004. Disponível e m : < h t t p : / / b v s m s . s a u d e . g o v. b r / b v s / p u b l i c a c o e s / politica_Nac_atencao_mulher.pdf>. 3. <http://www2.inca.gov.br/> [Brazilian National Cancer Institute José Alencar Gomes da Silva]

It was instructed about the importance of selfexamination, signs and symptoms of breast cancer, how to perform it and the need to look for medical 78 advice if a change is found . Subsequently, a dynamic

SCORA Mexico: the International Women Day Abdiel Barrera SĂĄnchez Margarita Itzel Gamboa Santos Carlos Alberto LĂłpez Silva IFMSA-Mexico

Letters to a warrior Letters to a warrior is a project born in SCORA Mexico, which has as main objective to sensitize the general public but mainly to medical students about depression that the majority of patients with breast cancer have during their disease by writing a letter to them where they express their admiration and support for them and thus also help improve the depression of these patients. What are the reasons for this project? In Mexico Breast cancer is the leading cause of hospital morbidity by malignant tumors in the population aged 20 years and over. Breast cancer is the second leading cause of death in women aged 20 and over (14.8%). Cancer diagnosis represents a hard to take event in the life of each patient, sometimes influencing negatively on their daily activities, their personal interactions and even personal integrity. From the moment of diagnosis patients are likely to develop clinical signs of depression, anxiety and discouragement secondary to a lack of support from their families and loved ones, a dehumanized approach from the medical personnel or absence of psychological counselling by trained personnel. All these factors can influence the development of the disease by showing a desertion in treatment by the patient or a refusal to access treatment. The project aims -Spread between the community the importance of mental health in women with breast cancer 79

-To sensitize students and medical staff about the importance of therapy and psychological counseling before, during and after diagnosis and treatment. This protocol population has targeted women of all ages, depressive situation by the news, treatment or sequelae of breast cancer. During the month of March, the month of women, the standing committee on reproductive health including AIDS. Mexico (SCORA) conducted projects for health of women, and one of them was letters to a warrior, which is next witness is by the local committee AEMUVPR, from Poza Rica, Veracruz. "One of the more humanistic and important activities we have done within the local committee is undoubtedly letters to a warrior, from the moment the active members received training on breast cancer and dealing with people suffering or they had breast cancer, we were able to see the importance of increasing and disseminating knowledge and information about breast cancer in both medical students and the general population, when having direct contact with the warrior, share experiences and experiences, deliver letters, see how a few words can generate many feelings and hope in them, really is magical. sometimes we find it difficult to fathom all the suffering that may come to have people, and as health personnel often are you immune to others' pain, but such projects makes you more sensitive and be more empathetic to other people, you put yourself in another's shoes and a link and a very emotional coexistence is generated, apart from everything, helps to the warriors who are fighting cancer or have already expired. â&#x20AC;&#x153;

Female Empowerment

we gave to them information about the menstrual cup and about the alternatives to the sanitary towels and conventional forms of monthly hygiene, and the conclusion was that the information is empowering.

“ E m p o d e ra m i e nto Fe m e n i n o” ( wo m e n' s empowering) is one of our favorite programs in SCORA México, because its one of the oldest programs and one of the more successful. In OEPSA the Local Committee of the Universidad Autonoma del Estado Mexico we did something different this year. One of our Active Members of the committee incorporated menstruation by talking about alternative as a topic in this program. The way she incorporated the menstruation was talking about alternative hygienic methods for the menstruation, specifically the menstrual cup.

Finally every woman chooses the method that better accommodates her, nevertheless a decision that is based on true and opportune information is a correct decision. that better accommodates her, nevertheless a decision that is based on true and opportune information is a correct decision. Prevention is your Choice

The menstrual cup is a reusable, bell-shaped cup that is worn internally and sits low in the vaginal canal, collecting rather than absorbing the menstrual flow. The menstrual cup empowers women to connect with their bodies and menstrual cycles like never before.

In Mexico, with a slightly larger population of 100 million people, breast cancer is now one of the most important health challenges of adult women. This situation is a little known fact, since besides misconceptions abound about the disease. Cervical cancer is still considered a greater threat to the health and lives of poor women and has spread the belief that breast cancer is notoriously concentrated in high socioeconomic groups. In fact, low-income women today face a double burden from high rates of cervical and breast cancer. Breast cancer is now deceased, in general, a greater number of deaths in Mexico, compared with cervical cancer, and affects adult women of all ages and income levels. It is currently the second leading cause of death among adult Mexican women aged 30 to 54 years old.

While planning the program the topic of the fear and rejection towards their own menstrual cycles arose amongst women. We mention that to menstruate represents an obstacle for the development of the daily and routine activities of the women, when it shouldn’t be. The primary reason for it be an obstacle, is the constant need to replace the sanitary pad or tampon, amongst other things. Another important aspect concerning the menstruation is the ecological load that this one represents for the planet. A woman a year spends an important money quantity and contaminates. A woman, approximately, has 60 days of menstruation a year and approximately menstruates for 38 years, what gives us like result 2280 days of menstruation in whole. The quantity of sanitary towels used during the whole life of a woman are thousands, what is equivalent to tons of garbage and thousands of money inverted. This one made represents an important quandary in the life of a woman.

In our work as medical students inside SCORA Mexico in the month of March we include the project "Prevention is your Choice" in which we fight against this health problem by approaching into the general population with workshops and conferences to spread the culture of early detection and awareness of risk factors as a crucial point to improve the health of Mexican women. Testimony of activities from the local comitee CEREMUG , from Leon, Guanajuato

When we throw the call for assistants to this workshop, many people showed its opposition to this type of activities. For our surprise many women also demonstrated against this workshop and the alternatives to the menstrual hygiene. The day of the event, the workshop returned in an opinion round table, the assistants shared their good and bad experiences with the menstruation,

We know that any medical student is familiar to any professor, doctor or someone else tell them about cancer, but how common it is for our people that we talk to them of this issue and the most important action is to take it to a population that unfortunately is completely unfamiliar with this subject, and is that ignorance one of the main factors that impact in such a drastic way on their health, as they have little knowledge about early detection importance and give little importance to have a regular examination.

Making â&#x20AC;&#x153;Prevention is your Choiceâ&#x20AC;? in our community was very rewarding, but also alarming, because we met women who had never went to their medical service for Papanicolao test or mammography before, especially they werenÂ´t familiar with the proper technique for breast self-examination. It Is hard to know that cancer is a health problem for all women, where survival rates can be improved if programs focused more on effective prevention and early detection, and this is what we try to spread into the population, prevention importance. conventional forms of monthly hygiene, and the conclusion was that the information is empowering.Finally every woman chooses the method that better accommodates her, nevertheless a decision that is based on true and opportune information is a correct decision.

CAPACITY BUILDING REGIONALÂ EVENTS

Sub Regional Training Ecuador 2016

Dear Americas Region, it is full of motivation and excitement that AEMPPI Ecuador has the pleasure to invite you all to be part of the Sub Regional Training Ecuador 2016. We are aware that capacity building is one of the most important bases of our Federation, so we saw hosting this event as an opportunity to provide a source of trainings to our beloved region and being more involved in the IFMSA by bringing people from all over the Americas to this paradise called Ecuador. As part of this Sub Regional Training (SRT) we will be having the Latin American Cooperation for Maternal Health and Access to Safe Abortion (LACMA) with the support from IPAS. We hope that having a workshop on Safe Abortion in a country where women face a  meaningful limitation to have access to it, will provide medical students in Ecuador and the  Americas with a platform to start advocating and raising awareness on this topic, besides setting the start to a huge renovation in Sexual and  Reproductive Health Rights in our region. Besides LACMA we are expecting to have four more workshops. A Training Experienced Trainers (TET) on External Representation, we want to improve the skills from our members when working with NGOs, medical faculties, fundraising and so on; besides the soft skills

A Training Old Trainers (TOT) with the aim of having many training workshops in the upcoming months where more and more members from all over the region can become trainers and through capacity building strengthen their organizations. Public health is one of the main pillars of the work in the Federation, it is linked basically with every activity we make however we consider the importance of it is not always taken as serious as it is in the education of medical students, based on this we are also preparing a Public Health Training. Last but least, our exchange program is known to be a remarkable characteristic of the IFMSA, besides one of the main support of many of our NMOs, that is why we want to host a workshop where participants can know more about this program, but more important the ways to make it even better in their organizations and the Federation.Our fifth workshop is the Professional and Research Exchanges Training. Ecuador is a multiethnic and multi-cultural country. Located in the middle of the world, is the home  of an immense biodiversity. Four worlds in one place, this is because of our four natural regions,  each of them is an entire world to discover. The country capital city is Quito. Is located in the middle of the world, 2.800 meters above the sea level, with more than 2.500.000 inhabitants, is the

same time, its capital and the first city to receive the nomination of the UNESCO as “Cultural Heritage of Humanity”. It has the largest and best preserved historic center in Latin America and possesses natural and exotic beauty, which has allowed it to be declared twice as the leading tourist destination in South America according to the World Travel Awards.

The accommodation, workshops and meals will take place in Reina Isabel Hotel & Suites. The Reina Isabel Hotel is very well located in the Mariscal area in the city of Quito, well known for its Cosmopolitan environment. The LACMA will be a five working day workshop with one day for arrival and one day for departure, starting on July 22 until July 28. The other four workshops will begin on July 24 until July 28.

Quito is only the beginning of a magical adventure. From the capital you can travel and meet the 4 worlds that Ecuador offers to you. Beaches on the coast, the mountains in the highlands, the biodiversity of the Amazon and the enchanted Galapagos Islands are waiting for you with open arms. Here you will learn to love life.

The proposed fee for now is 260 USD, including accommodation, meals and workshops. In the case of LACMA the fee will be covered by the IPAS grant. Our social program will focus on getting you to know the historical and beautiful city of Quito and having a great time enjoying the night life. Be ready for an amazing event that the region deserves. See you all in Quito

For more information, you can visit http:// ecuador.travel/en/destino/15/quito We are such a welcoming country that NO visas are required to visit Ecuador for a period of 90 days per year.   Supported by

Sub Regional Training Mexico 2016 The SRT is just around the corner and Mexico is honored to welcome you this summer with arms wide open. The City of Queretaro anxiously awaits the opportunity to make you live your best days, in which you will not only take part in the most amazing workshops to become great trainers, but also get to meet wonderful people and lifelong friends, in the unique way only IFMSA knows how to. The workshops, which we know you will make the most out of, are: TNT, TET on Communication Skills, PRET, LEAD, and Disaster Medicine. The SRT Mexico 2016 will take place from August 10th to the 14th, in the beautiful city of Queretaro, México, designated World Heritage City by UNESCO. Santiago de Queretaro is the capital of the State of Queretaro, located in the center of Mexico. Santiago de Queretaro was founded in 1531, among bloody battles between native Indian and Spanish conquerors. Under the protection of the Apostle Santiago, who appeared in the skies in order to seal with his image the cultural mixture of which became the third colonial city of the XVIII century. We’d like to mention that Queretaro is only 4 hours away by bus from Puebla, the host city for the August Meeting 2016. Top Historical Sites in Quéretaro: The Aqueduct: With 74 arches of quarry, a maximum height reaching 23 meters, and stretching across 1,280 meters, the Aqueduct is certainly a symbol of the city of Querétaro that can be seen from many locations in the distance and can be seen up close for a great photo.

Centro Histórico (Historic downtown): Queretaro is characterized for its colonial architecture and its beauty, and can be considered the hotbed of history in the state, or even Mexico, starting with the historic center or Centro Histórico. Querétaro is the first state where Mexicans declared their independence. It has many monuments, museums, haciendas and other historical sites for you to enjoy. And that’s why it is no wonder that the capital of the state, Santiago de Querétaro, has been designated a World Heritage City by UNESCO, like we previously mentioned. As such, Querétaro is one of the best places in the country to make it your base for exploring colonial Mexico. Teatro de la República (The Republic Theater): Inaugurated in 1852 and named Great Iturbide Theatre, this theater held many events that defined the history of Mexico. Today international artists perform different shows and concerts here, as well as the performances of music from all times by the Philharmonic Orchestra of Queretaro. Peña de Bernal (Bernal’s Boulder or Bernal Peak) Is the second-largest monolith in the world, after Mount Augustus, Western Australia. At 350 meters (1150 ft) it is also the fourth-tallest monolith in the world, after Mount Augustus, the Rock of Gibraltar and Sugarloaf Mountain. Peña de Bernal is located in San Sebastián Bernal, a small town in the state of Querétaro. Many people make a pilgrimage to the highest point hikeable, visiting a little chapel about halfway up. Things to do here: • Peña de Bernal – Climb the second-largest monolith in the world (about 350 meters high). • Rock Climbing – There are many multi-pitch sports routes on la peña. There are also more routes and some bouldering near-by el captain.

• Shopping – The town of Bernal is full of shops that sell locally made souvenirs, arts and crafts, and clothing. This is a great  place to find unique items.

Parallel to this historical environment is the fresh and fun Queretaro, offering attractive options of music to dance or listen, different sorts of live shows and a great variety of international and Mexican cuisine. The historic downtown callejoneadas (night  promenades by the alleys or narrow streets) accompanied by estudiantinas or rondallas are  famous, as well as the performances of music from all times by the Philharmonic Orchestra of Queretaro.

• Eating out – Enjoy local restaurants that serve delicious traditional meals, and drinks. Sierra Gorda Approximately 3 hours from Santiago de Querétaro lies the lush Sierra Gorda, an ecological region that covers the northern third part of the state of Querétaro and extends into the neighboring states of Guanajuato, Hidalgo, and San Luis Potosi. This is a must visit destination in Querétaro for ecotourism.

Food and Drink One of the best features of Querétaro is the great food that you can enjoy in this state. Those who come here are left longing for the delicious cuisine. Queretaro is known for traditional Mexican dishes such as tacos, gorditas, tortas, pozole, as well as great seafood and international foods such as Italian, Oriental, and American food with a Mexican twist, such as hamburgers. It will be impossible to try all of the variety of dishes you can get in Querétaro in a single visit.

Tequisquiapan Tequisquiapan, commonly referred to just as Tequis by locals, is a colonial town in southwestern Querétaro, less than an hour’s drive from Santiago de Querétaro. The tradition of this town as well as its climate and local natural water springs, have made this town a popular weekend getaway for people from Querétaro and Mexico City. In recent years Tequis has also become a popular destination for expats to settle in. Another attraction is the fact that Tequisquiapan is part of Querétaro’s Ruta de Vino (Wine Tasting Route). The winery, La Redonda, is the municipality’s major producer.

If you are not in the mood for a big meal, you can enjoy light refreshments, pastry, coffee, or just a drink. There are many cafes in Querétaro that serve excellent Mexican coffee, freshly baked pastries, and more.

A thousand words cannot describe the beauty, history, taste, pride, and passion that is not only present in the City of Querétaro, but in every corner of our beloved Mexico. We invite you to take this amazing opportunity to discover one of the most exquisite cities in Mexico, to savor the greatest food you ever had, and to fill yourself with that joy that can only be found in Mexico. Do you dare? Live the experience!

You can find an establishment with just the right atmosphere, whether that may be an outdoor patio with a park setting, historic colonial architecture, city scape, or a breathtaking mountain range. To go along with your meal, you can enjoy a cold Mexican beer, wine from the best wine producing regions of Mexico or other parts of the world, or a Michelada (a drink with beer and spices). Top off the night with some fine tequila. You haven’t really experienced Mexican cuisine without visiting Querétaro.

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